HomeMy WebLinkAbout170 Hillside Drive (2)a
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DEPARTMENT llECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WIl TDSOR
PERMIT#
Application is hereby: 1 7U 3BUILDINGDEPARTMENT
APPROVED 1540 SULLIVAN AVENUE Bldg.Permit#
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644-2511 ext. 230 7
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
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70 r or
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
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or any fraction thereof Tenant Designation Apt.No.
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APPLICANT w ro V e— 1
APPLICANT ADDRESS
APPLICANT PHONE# G a 0 7
W N S OWNER li'(4 e
OWNER ADDRESS 301
J i••% Ill N 1
OOWNER PHONE
C ESTIMATED COST$ 3 0 D
3
IS THIS A CONTRACT COST? Yes No
5 0oFEEENCLOSED$
TYPE OF JOB:
OR-CO New Installation
Iteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF 3XILDING:
4MEATING LTRESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
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STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC WARM AIR UNIT RADIANT HEATER
aXISTING RADIATION ADDITIONAL RADIATION~OTAL RADIA ON
DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY(INPUT-BTUH) JTET RATING(OUTPUT-BTUH) G ®ate
TYPE OF FUEL
OIL-GPM OIL TANK LOCATION:INSIDE OUTSIDE CAPACITY
GAS-INPUT LPG TANK CAPACITY ELECTRIC-KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH) HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
TONNAGE COOLING CAPACITY(BTUH)
VENTILATION
DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
PLANS MUST ACCOMPANY APPLICATION)
FURTHER DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND IS TO
COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE
PERFORMANCE OF SUCH WORK.
CONTRACTORS LICENSE NO. TYPE STATE
4
SIGNATURE OF APPLICANT DATE 3- .21• O 3
S-T 12 4 8 7 RIGHT-J SHORT FORM 3-19-0 3
File name: HANY RAY.bld
Job#: Htg C1g
For: Outside db 10 100
170 HILLSIDE DR. Insidedb 70 70
SOUTH WINDSOR CT DesignTD 80 30
Daily Range M
Inside Humid. 50:
By: The New Shepard Supply Co.Grains Water 35
369 Talcottville Rd. Method Simplified
Vernon CT 06066 Const.glty Average
860-875-2545 Fireplaces 1
HEATING EQUIPMENT COOLING EQUIPMENT
Make Make
Model Model
Type Type
Efficiency/HSPF 0.00 COP/EER/SEER 0.00
Heating Input 0 Btuh Sensible Cooling 0 Btuh
Heating Output 0 Btuh Latent Cooling 0 Btuh
Low Output Basebrd 550 Btuh/Ft Total Cooling 0 Btuh
Total Low Basebrd 14 Feet Actual Cooling Fan 0 CFM
High Output Basebrd 780 Btuh/Ft Clg Air Flow Factor 0.000 CFM/Btuh
Total High Basebrd 10 Feet
Space Thermostat Load Sensible Heat Ratio 0
ROOM NAME AREA HTG CLG BSBRD FT CLG
SQ.FT. BTUH BTUH LOW HIGH CFM
ADDITION 176 7756 0 14 10 0
Entire House 176 7756 0 14 10 0
Ventilation Air 0 0
Equip.@ 1.05 RSM 0
Latent Cooling 0
TOTALS 176 7756 0 14 10 0
MANUAL J:7th Ed.RIGHT-J:V3.0.15
y lo 0
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fl_- 50 c w N
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