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HomeMy WebLinkAbout0 SPRING MEADOW RD BLDG 3 DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Application is hereby. TOWN OF SOUTH WINDSOR 300 � BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE 644-2511 ext.230 Bldg.Permit# Date Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: 309 Spring Meadow Rd $0-$1,000 Q$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT All Plumbing Repair, Inc./Mike Marandino APPLICANT ADDRESS P.O. Box 853 Tolland, CT 06084 APPLICANT PHONE# (860)870-5325 SOW N 8 OWNER Iris Donate OWNER ADDRESS 309 Spring Meadow Rd South Windsor, CT 06074 r ty OWNER PHONE (860)869-1479 O C ESTIMATED COST$ 850.00 IS THIS A CONTRACT COST? X Yes _No FEE ENCLOSED$ 15.00 OR-00 TYPE OF JOB: New Installation x Alteration/Addition/Repair t�013oc�a3 Revisal 410182002 I (Continued from reverse side APPLICATION FOR PLUMBING PERMIT(Contra ) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A BUILDING PERMIT APPLICATION? ❑YES❑NO ®RESIDENTIAL 0 A SINES Y CURRENT USE AND OCCUPANCY 13 0 MB ME CA OVAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑STORAGE ❑GARAGE ADDRESS ❑MIXED USE CITY STATE ZIP (Other please specify) TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS STYLE NO.URINALS STYLE NO.OF BATHTUBS NO.OF SHOWERS NO.OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE Electric MANUFACTURER State Kenmore DESCRIPTION OF WORK Replace existing 55 gallon electric water heater ]'HE UNDERSIGNED HEREBY APPLIES FOR A AND is TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. 204858 P-1 CT CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE `-a S-,3 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: 3 BUILDING DEPARTMENT APPRO 1540 SULLIVAN AVENUE Bldg.Permit# -,=,f�._!�� (� 644-2511 ext. 230 Date. Building Inspector Application must be printed or typed FEE SCHEDULE Location of Job: sp�lc):2 r,()P-Odaul $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT—A. h 1 e APPLICANT ADDRESS U 1 APPLICANT PHONE# �; -t L/O:-1 OWN Sc OWNER r OWNER ADDRESS /S 4� OWNER PHONE C ESTIMATED COST$ IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ L4-` r1V�s TYPE OF JOB: R C New Installation AAlteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: A�EATING RESIDENTIAL ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LRvIIT LBS. ❑HYDRONIC ❑WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) =rci a� op OT—W& J�l OW GROSS 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 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)e0J 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 SIGNATURE OF APPLICANT `� � DATE $-7 'CD Page 1 8/6/2003 Residential Heat Loss and Heat Gain Calculation In accordance with ACCA Manual J Registered To: Aiello Plumbing Heating and Air Conditioning For: Petricca Carlyn 305 Spring Meadow Road South Windsor, Ct 06074 Design Conditions: Windsor Locks,Bradley Field Indoor: Outdoor: Summer temperature: 72 Summer temperature: 95 Winter temperature: 70 Winter temperature: -6 Relative humidity: 50 Summer grains of moisture: 93 Daily temperature rangeMedium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 608.8 sq.ft. 13,415 1,426 14,841 26,274 ( 1 tons) Second Floor 13,415 _1,426 14,841 26,274 All Rooms 609 sq.ft. 13,415 1,426 14,841 26,274 Whole House 608.8 sq.ft. 13,415 1,426 14,841 26,274 ( 1 tons) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads rney vary due to weather and construction differences. � oELL6 CORPORATE OFFICE PLUMBING, ELECTRICAL, 11 WILSON AVENUE-WINDSOR,CT 06095 HEATING & AIR CONDITIONING .t January 24, 2003 To Whom This May Concern: Aiello Plumbing, Heating & A/C authorizes Peter Butler to pull permits for our company for plumbing, heating and air conditioning installations. If you have any questions you are requested to contact our office at 688-4881 Sincerely, I// Michael Jezouit Owner/President Windsor Manchester Enfield Avon New Britain Glastonbury Middletown (860)688-4881 (860)648.2397 (860)745-1783 (860)673-7377 (860)225-5523 (860)633-3108 (860)346-8144 FAX(860)244-2820-TOLL FREE 1-888-956-4455 - CT Lic.P1-203350-S1-3nZna7 o,)n e;- ZEE STATE OF CONNEC I T CU'T'4:'*-'-6viD I M NS XZJ' 9 R kbTECTION Be it known that 7 MICHAE f, L R JEZOUIT 7"1 -41 W, N VE 95 F has been certified by the Burner Protection as a licensed HEATING;PIPING & C ent IMITED-CON-r- E: S1 RACTOR st Effective: 09/01/2002 Expires: 08/31 2003 J&`('XTAFk'4*MLn9Q-Comm loner STATE OF CONNECTI T + DEPARTMENT OF CONSUMER PROTECTION Be it known that MICHAEL R JEZOUIT I I WILSON AVE WINDSOR, CT 06095 has been Certified by the Department Of Consumer Protection as a licensed LIMITED SHEET METAL CONTRACTOR TYPE: SM1 License # 5345 f f ect,ve: 09/01/2002 Expires: 08/31 2003 Jam 3 T. Fleming.Comm 43ioner i DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is hereb : TOWN OF SOUTH WINDSOR It S '� BUILDING DEPARTMENT APP OVED 1540 SULLIVAN AVENUE Bldg.Permit# Z1 6!> 644-2511 ext. 230 Date B ildin Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT A It-t 6 APPLICANT ADDRESS I W i rY1l�,cp-r , - �Qr)rn (�yS APPLICANT PHONE# 6-,RE — Lq[QX O W N St OWNER, q� OWNER ADDRESS „ OWNER PHONE 0 C ESTIMATED COST$ , � IS THIS A CONTRACT COST? Yes _No a,. (� FEE ENCLOSED$ 1�OS O � TYPE OF JOB: �R-C _New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: ❑HEATING ❑RESIDENTIAL 1/C ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC ❑WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F WAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS 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 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 1STATE SIGNATURE OF APPLICANT �� DATEd/ Page 1 9/10/2003 Residential Heat Loss and Heat Gain Calculation In accordance with ACCA Manual J Registered To: Aiello Plumbing Heating and Air Conditioning For: Wywoda Kathy 304 Spring Meadow South Windsor, Ct 06095 Design Conditions: Windsor Locks,Bradley Field Indoor: Outdoor: Summer temperature: 72 Summer temperature: 95 Winter temperature: 70 Winter temperature: -6 Relative humidity: 50 Summer grains of moisture: 93 Daily temperature rangeMedium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 828 sq.ft. 12,038 1,774 13,812 31,044 ( 1 tons) First Floor 12,038 1,774 13,812 31,044 All Rooms 828 sq.ft. 12,038 1,774 13,812 31,044 Whole House 828 sq.ft. 12,038 1,774 13,812 31,044 (1 tons) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load calculations are estimates only,actual loads may vary due to weather and construction differences. �ltJu`+lJu`+Ilu��llu�OJu`71u�7Ju`71u�7Ja`�lJu`71u�7Ju`�l1u�OJu`�Ju`�Ilu��llu`�l1u`71u��IJu��lu`aJu`OJu�0Ja�0Ju`7Jo`vJu`71u��J�e e STATE OF • DEPARTMENT OF CONSUMER e . . • • Be it known that MICELAEL R JEZOUIT PQ PPX 200 : �. 1 0 • • +.0• r has been certified by the Department oi-& •er Protection as a licensed G SHEETLIMITED • �. TRACTOR froi G► • ' • . N ► • • +► l. `. • 0.4/31 2004Jads T. Fie ing.�commisstoner r e G a/G1►►�01►��01+►(01����1+►�Ol+►�O�+►�01+►�01+►�01+►�Ol+►�O�+►�01+►�0�+►COI+►�Ol+►�01+►�01+►�01+►�Ol+►COI+►�Ol+►�01+►�Ol+►COI+►COI+►COwOjt — STATEOF • DEPARTMENT OF CONSUMER e Be it known that - AHCHAEL R JEZOUIT G. • BOX 200 has been • by P Department . • • Protectioner G' • . P• Effective: 09/01/2003 • 1 :2004 • oner o �►lel+►�©1+►/Ol+►(01+►�01+►�01+►�Ol+►�Ol �Ol!01�Ol �01 (01(01 (01+►(Ol+►(01+►(Ol+►(01+►(Ol+►(O�+► a +,' . ►. � u u +► u u u u � (01�01 (01+(01+►�©1+►(01+►��1+►�01� I i A19LL6 CORPORATE OFFICE 11WILSON AVENUE-WINOSOR,CT0609s PLUMBING, ELECTRICAL, HEATING & AIR CONDITIONING j May 2;2003 To Whom This May Concern: Aielro Plumbing,Heating&A/C authorizes Peter Butler to pull permits under license numbers S1303032 and P1203350 for our company in regards to plumbing, heating and air conditioning installations. If you have any questions you are requested to contact our office at 688-4881 Sincerely, Michael Jezouit Owner/President Windsor Manchester Enfield Avon New Britain Glastonbury Middletown (860)688-4881 (860)648-2397 (860)745-1783 (860)673-7377 (860)225-5523 (860)633-3108 (860)346-8144 FAX(860)244-2820-TOLL FREE 1-888-956-4455 - CT Lic.P1-203350-S1-303032-E1-121 q?q DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Appli ' n is TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPR 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Dat Building spector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 FTfein-antDe Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT e 16I� APPLICANT ADDRESS Ld t (1 W11nA----Dpf, = nco APPLICANT PHONE# aq- !V g OWN St OWNER E I. I 1 OWNER ADDRESS Z OWNER PHONE CO = ESTIMATED COST$ Ld y 8-7 ,-7 9 IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ `-] , nn TYPE OF JOB: SO R;Co New Installation /Y�Alteration/Addition/Repair Revised 410IH2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF YSTEM: TYPE OF UILDING: VTING RESIDENTIAL ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑STEAM LOW PRESSURE LB41T LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC ❑WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) Hf4aL POMD GROSS HEATING CAPACITY(INPUT-BTUR) 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 OF TOTAL HEAT GAIN(BTUH) (HEAT GAIN SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL COOLING EQUIPMENT(INCLUDING MAKE&MODEL NO.) -r(A) TONNAGE - COOLING CAPACITY(BTUH) VENTILATION DESCRIBE ALL AIR HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT) TOTAL SIZE OF SYSTEM(CFM)Ro�) FRESH AIR INTAKE(CFM) (PLANS MUST ACCOMPANY APPLICATION) I f� FURTHER DESCRIPTION OF WORK F-FQ a? C'I_ XlC P� r smT Dr�mP 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. - Q LESI C� CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT ! DATE I0-13-03 Page 1 10/13/2003 . Residential Heat Loss and Heat Gain Calculation In accordance with ACCA Manual J Registered To: Aiello Plumbing Heating and Air Conditioning For Ellen Ricketson 302 spring meadow rd. south windsor, Ct.06074 Design Conditions: Windsor Locks,Bradiey Field Indoor. Outdoor. Summer temperature: 72 Summer temperature: 95 Winter temperature: 70 Winter temperature: 0 Relative humidity: 50 Summer grains of moisture: 93 Daily temperature rangeMedium Building Component Sensible Latent Total Total Gain Gain Heat Gain Heat Loss (BTUH) (BTUH) (BTUH) (BTUH) Whole House 1,114.3 sq.ft. 15,618 1,660 17,278 32,169 (1.5 tons) First Floor 5,460 835 6,295 18,338 Bathroom 29 sq.ft. 380 52 432 10368 Kitchen 99 sq.ft. 638 77 715 2,797 Hall 39 sq.ft. 526 181 707 2,504 Living Room 440 sq.ft. 3,916 525 4,441 11,669 Second Floor 10,158 826 10,984 13,831 Hail 30 sq.ft. 0 0 0 0 Bedroom 1 234 sq.ft. 5,150 413 5,563 7,019 Bedroom 2 162 sq.ft. 3,568 275 3,843 5,016 Bathroom 81 sq.ft. 1,440 138 1,578 1,796 Whole House 1,114.3 sq.ft. 15,618 1,660 17,278 32,169 { 1.5 tons) HVAC-Calc Residential 4.0 by HVAC Computer Systems Ltd. 888 736-1101 Load oalculabom are e0mab n only,actual bads may vary due to weather and construction differences. AIELL61= - CORPORATE OFFICE PLUMBING, ELECTRICAL, 11 WILSON AVENUE-WINDSOR,CT 06095 HEATING & AIR CONDITIONING May 2,2003 To Whom This May Concern: Aiello Plumbing, Heating&A/C authorizes Peter Butler to pull permits under license numbers S1303032 and P1203350 for our company in regards to plumbing, heating and air conditioning installations. If you have any questions you are requested to contact our office at 688-4881. Sincerely, Michael Jezouit Owner/President Windsor Manchester Enfield Avon New Britain Glastonbury Middletown (860)688-4881 (860)648-2397 (860)745-1783 (860)673-7377 (860)225-5523 (860)633-3108 (860)346-8144 FAX(860)244-2820-TOLL FREE 1-888-956-4455 - CT Lic.P1-203350-S1-303032-E1-121929 s�l°�7�°�7IU�71u�71+►�71��71+►�'�Ju�71a`�lla`71a`71a`qla�lJa`!Ja`!lu`!la`!hl`!/u`!lo`!)a\!)ullla`!)a`!Ia`!JU`�!J�`�!Ja�!)� Be it known that NUCHAELR TEZOUITa 1/ 1 . Ok�-"bTV6095 has been certified by the DepartInent . . ►..er Protection as a licensed G LIMITED �1 1 • • • w G t G G 1• 1 11 `. • O.V31 .r 2004 crq - - ----- a :r albl�'1i111�1i11+►1i11+'1i11+'141+�1�1+'1�1+►1(l�+�l��+►141+�1(►1+'l(11+�((��+�1(11+'<�1+�1(►1+�!(�1+'l(►1+►1(11+'l(U+�141+'l(11+►lilk+�l(11+'10�+'10�+'1�1+'1t11R �`Ju`�I•`�IU`�lukqpI4\jI U`�I�`�JU`�I�`�14`�lU`�IU`�I�`�I U`��U`���`•I�`���`��u`!�°`•�p`���'`•�°`��°���''`�14�71u`'!ly`�l GSTAT E OF • DEPARTMENT CONSUMER . . • • G YUCHAEL R JEZOUIT PO BOX 11 WIND SOR��TZO'6095 has been certified 1by the Department ofCQnuiner . . • • • • 1 1 1 CONTRACTOR TYPE: License ..3.09032 Effective: 09/0L,2003 ExpireW8/31 2004 Jam s T.Fleming.�commjssjoner ---- G a�6�"liil"1i�1+'1i�1�'1i�1�'101�'101�'101�'101���01+'�01u u v 01+'a41ug1+'&011'�01�►�01�'�01�' DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# A licatio ' TOWN OF SOUTH WINDSOR pp y BUILDING DEPARTMENT Z27 APPRO 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 N • Date Bufffing Inspeceur Application must be printed or typed FEE SCHEDULE 3D�o Location of Job: n / $0-$1,000=$15.00 Street No. Str et Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof tenant Designation Apt.No. APPLICANT #NKs44 ;e T�tG APPLICANT ADDRESS Lao 141e j#C /2 C r APPLICANT PHONE# go—fio—Po o O W N S f,q OWNER ..,�j /�7yc�t OWNER ADDRESS /S Rwbcwo�/ �►" Cr- 06.zj O! • OWNER PHONE ffLb F75-- 0/37 C = ESTIMATED COST$ IS THIS A CONTRACT COST? Yes _No �i✓ FEE ENCLOSED$�20, 4 l��s 0�� TYPE OF JOB: R C _New Installation Alteration/Addition/Repair Revised 4/01H2002 APPLICATION FOR HVAC PERNUT (Continued from reverse side) TYPE OF STEM: TYPE O � F LDING: UHEATING CT RESIDENTIAL jV A/C ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑STEAM LOW PRE URE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT-BTUH) Al, NET RATING(OUTPUT-BTUH TYPE OF FUEL ❑OIL--GPM OIL TANK LOCATION:0 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 ) �L COOLING CAPACITY(BTUH) P XO 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. s't-39l/0c 5'( c i CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE