HomeMy WebLinkAbout210 Avery Street (7)DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
Application is hereby:TOWN OF SOUTH WINDSOR PERMIT#
BUILDING DEPARTMENT 17
APPRO 1540 SULLIVAN AVENUE Bldg.Permit#
Z7 03 644-2511 ext. 230
ate Building Inspector
a a73
Application must be printed or typed
FEE SCHEDULE Location of Job:
Street No. Street Lot No.Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
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APPLICANT
APPLICANT ADDRESS
APPLICANT PHONE# 49L cj- a Cj
Ow N 8,0 OWNER PP a V 1 A..,, g
OWNER ADDRESS
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E., OWNER PHONE 01$'). • O C13 01ci
C ESTIMATED COST$ S,ace y`
U
aw IS THIS A CONTRACT COST? 4—Yes No
1 C FEE ENCLOSED$ Q
TYPE OF JOB:
soR,Co New Installation
Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF UILDING:
EATING RESIDENTIAL
A C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
HYDRONIC XWARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE O OF INSIDE ka OF DIFFERENCE J% OF
TOTAL HEAT LOSS(BTUH) C)3c V°F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
N 6 3L(9 z 4'lou 94 o /0 V f
GROSS HEATING CAPACITY(INPUT BTUH)w NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
OIL—GPM OIL TANK LOCATION:INSIDE OUTSIDE CAPACITY
X'GAS—INPUT LPG TANK CAPACITY ELECTRIC—KW
AIR CONDITIONING
DESIGN TEMP.OUTSIDE OF INSIDE > OF DIFFERENCE OF
TOTAL HEAT GAIN(BTUH A4r, (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION)
DESCRIBE ALL COOLIN E 1 ENT(INCLUDING MAKE&MODEL NO.)
TONNAGE 3 'Z COOLING CAPACITY(BTUH) 472 ctiv
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 ljv w ^ +L
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.
3 Z> sr-v S—] G1
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT Q,O L `s c DATE C 4 13
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Form N ,HD.611.kAl2)S•T8-i32 JOB NO.
LENNO HEATING DATA SHEET DATE BY..!.-..h..•.`-..
OUTSIDE DESIGN TEMP.._.. .G..._......_._._.._.....
tA
HEATING CONTRACTOR [—G/1S[ l/•- I I C..+.._ADDRESS _._....._....._._...t',.r n` 5__..__.__._..._.__........_INSIDE DESIGN TEMP. .... . . .....................
NAME OF JOB-_.--_. o v _L +i••_.LS"' ADDRESS ...- .l.s...._ l tJ{'^ DESIGN TEMP. DIFF. ........1.G'._...._.
1. R m Use and Floor Lev 1 I. P r i 2•a ti •-- 3. 4v ti. 4• t••• (- 5. v i / 6. p t r. 7•C n B.
2. R om Length and Width Y, A-
3. Running Ft of Exposed Wall 3 2 d qi- C t 7b
4. Ceiling Height S ci F P S Ci r
5. Exposure Table "U" Mutti- Area soh Area stub Area ltuh Area etch Area Etch Area Pub Area gtuh Area Pub Area Bfuh
No. Crack Crack Crack Crack Crack Crack Crack Crack Crack
Type Factor plier Cfm Loss Cfm Loss Cfm Loss Cfm Loss Cfm Loss Cfm Loss Cfm Loss Cfm Loss Cfm Loss
Gross 1 \. M AliY• j r:
l tT"'r;.e. S i !j:1r r iy} .'. 6I,
5,
b. Exra:ed
Pit i1, ri Ol" `N',' `• l
C y' j• «mil +----- •
y,.. . i'vi l.•
i. r i_ 1 'I j7 FWallpyG ,IS. . k,s' ea.L ... 1 G• `i:
r.
Windows
7. and s-
Doors p
Net
S. Expos d
Wall
9. Cold
Partition
10. Cold
000' / C. 1 .7 •r •
J
Ceiling
11. Cold
Floor
f
Infiltration,
12. (Leakage(
r
Air Change
q
13. R om Sub-iotal Btuh S'( Z U G 7 S r A A L
14. Bfuh Adjustment
15. Room T tal Bfuh
16. Cfm @ Temp.Rise
17. Adjust d cfm
LENNOX Equip3 lw Blow r p_.______-..___..C nstructi nMotorh
Bfu6 (Input-Output) /OA 0,0 G f) ' '9 3.')V r2 Cfm_ r-..._____._.._.......__.__.._..._Drive:.-._.._..... _ Ventilation Loss.
Fuol_ t`AA \ Co.n S.P Rpm_ ____ T fal
V - 1ffill mOFi Sm MINIM
Area Area Area Area'
or
No No NoNo.1 9 1mlmGainGainGain
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