HomeMy WebLinkAbout2719 Ellington Road (2)s
l
7ApplicationRTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT#
is hereb :
TOWN OF SOUTH WINDSOR s-kyBUILDINGDEPARTMENT
App 1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230
a
ate Building Inspector
Application must be printed or typed
Location of ob:
FEE SCHEDULEEj9
0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT MA-0
APPLICANT ADDRESS
APPLICANT PHONE#
OWN $F
OWNER
4 OWNER ADDRESS
OWNER PHONE
ESTIMATED COST$
IS THIS A CONTRACT COST? XYes No
FEE ENCLOSED
TYPE OF JOB:
SOR*CO New Installation
j(k1teration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF BUILDING:
ALHEATING gRESIDENTIAL
A/C COMMERCIAL
VENTILATION INDUSTRIAL
HEATING
STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
A HYDRONIC WARM AIR UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE --A0 OF INSIDE F DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) Q °F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GIMSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH)
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 F
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.
c QD`XJ t
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT_Ioe Z6gDATE IdI11 14!5
B= R CALCULATION SHEET 7503 (Modern Method). The Hydronies institute,35 Russo Place,Berkeley Heights,N.J.07922
I AA
NER ADDRESS DESIGNDESIGN TEMPERATURE DIFFERENCE-ILF. DATE !4 `V a
COL.A OL.S COL.C COL.D _ COL.E COL.F COL.a
ROOM p
0 H L W H L W H L W M 1. w H L w Design water Temp. S.L._._......
ROOM DIMENSIONS,FT. v f
BTUH per Feet of OO
1 LENGTH EXPOSED WALLS,FT. d Radiation Selected Ot
I WINDOW AND OUTSIDE DOOR'AREA
BTUH STUM BTUH STUN STUN
i WALL CONSTRUCTION ROOM LIN.FT.OF
Tanta 9,Line 3 x H)1 DD TOTALS RADIATION
FROM LINE 12 SELECTED
I TYPE OF GLASS. IwooftableusedforLine5) 3
CEILING CONSTRUCTION O C
Table 9,L x W)D
1 FLOOR CONSTRUCTION(
Table 9,L x W or Lin. Ft.) C . E
1 COLD PARTITION CONSTRUCTION F
Table 9,L x")6
d 1 Wall(With Openings) rJr
cy 2 Wail*(With Openings)J 1
3 Walls(With Openings)or Ent.Hall
J
I TOTAL 13TUM AT 70F TEMP.DIFFERENCE'
K-
TOTAL BTU" AT DESIGN TEMP.DIFFERENCE
L
COL.A COI..8 COL.H COL. I COL.J COL.K COL•L TOTAL BTUH TOTAL
OF BUILDING RADIATION
ROOM Q AT SELECTED
O M L W H L W H L w H L W M L W. DESIGN TEMP.•
DIFFERENCE
I ROOM DIMENSIONS,FT. I'
V
I LENGTH EXPOSED WALLS,FT. d
I WINDOW AND OUTSIDE DOOR AREA
STUM TUH STUM STUM BTU"
S WALL CONSTRUCTION INCREASE BATHROOM
Table 9,Line 3 x H) TOTAL 30'K
I TYPE OF GLASS
Bottom of table used for Line S)tFOR CONCRETE FLOOR ON
CEILING CONSTRUCTION GROUND OR FILL AT
Table 9,L x W) GRADE LEVEL,USE LINEAR
FLOOR CONSTRUCTION•
FEET OF EXPOSED EDGE
Table 9,L x W or Lin.FL)
I COLD PARTITION CONSTRUCTION
Table 9,L x H)
3 1 Walt(With Op•nirpd
1% 2 Wells(With Opervinjo Ix
3 Wells(With Openi F JborEnt.Hell
I TOTAL BTU"AT 7OF TEMP.DIFFERENCE*
t TOTAL 11jTUH AT DESIGN TEMP, DIFFERENCE
FORM 1S03