HomeMy WebLinkAbout10 BARBER HILL RD DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR Z Z O
BUILDING DEPARTMENT
1540 SULLIVAN AVENUE Bldg.Permit#
644-2511 ext. 230 N�
at, g ns ---
Application must be printed or typed
FEE SCHEDULE 78 J Lo ation of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
/ 7
APPLICANT 0,
APPLICANT ADDRESS (1YY
/� p /
APPLICANT PHO #/ 6�V - ��0 O 7 C' l
W N 3Fq OWNER CS c'T� �t17
O,�
OWNER DHR�SS 12
O # OWNER PHONE
C ESTIMATED COST
IS THIS A CONTRACT COST? _Yes /-No
O _ � FEE ENCLOSED$ 75 , yV
sco
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:
1'd HEATING J24RESIDENTIAL
❑A/C ❑COMMERCIAL
❑VENTILATION ❑ INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
,OHYDRONIC ❑ 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) NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
-OIL—GPM %9SOIL 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. STATE
SIGNATURE OF APPLICANT ` D -1 DATE ��
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;.I AY 0 81990
South Windsor
BUILDING DEPARTMENT
TO THE BUILDING DEPT. TOWN Of SOUTH WUaDs.-,
This certified that this plan and specifications are to
copies of the proposed building or akerations to L.
erected at
/o 0&C:.e Street
together with amendments stated in application an.
filed with plan and 1 agree to comply with all zoning,
Building and state laws and such orders as shall L.
issued by the Building Department during pendenc•
of this appl4tion and final issuance of a buildi
permit.
i Signed
This IF
plan Is approved subject to the condition that
-- orders and ordinances rayulating tw Tiding shall be
complied with.
Conditionally Approved ]'base filed with
Building Inspector Clerk
A. _--s r Na' —_44
.,,.�.i;i iHUA i IUN OF ZONING COMPLIANCE
Proposed building(s), use(s) and/or structure(s)
eyc�ose� =:s shown on this plan appear(s) to be in
conformance with current South Windsor
i_ttions. Variances and special exceptions
. ay apply.
.gate
01
✓�?�v tr; it��
Srder-rck Oo') Ving Enforcement Officer
gam,. Qt t IR%4 .
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