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HomeMy WebLinkAbout104 WYNDEMERE CT BLDG 1 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT — APPROVED 1540 SULLIVAN AVENUE •�� , Bldg.Permit# 644-2511 ext. 230 , Date ilding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: F � G�$0-$1,000=$15.00 Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof gnation Apt.No. APPLICANT c��� O ` �d APPL CANT ADDRESS G /� S 77--, 06C 7 - -- APPLICANT PHONE# AljO SZ 8—6? 6 6 O W N Se OWNER (Gt 0-1/ OWNER 7DREESS ��- (� 4j n Q �5, C f C Oa OWNER PHONE b © Y'9 7 Rl g C = ESTIMATED COST$ 751 xb t, IS THIS A CONTRACT COST? _Yes Z--Iqo FEE ENCLOSED$ 7 S GU Rl��s O�� TYPE OF J0 C New Installation _Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR RVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: ❑HEATING ❑RESIDENTIAL ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEATING ❑S EAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. =RONIC ❑WARM AIR ❑UNIT RADIANT HEATER EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION DESIGN TEMP. OUTSIDE OF INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) cD SCRIBE ALL HEy�TING EQUIPl GENT(INgLUD44G MAKE&MODEL NO.) GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH) TYPE OF L pPOIL—GPM I' 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 WORKd/�C� 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. __?0 37 8 2 CONTRACTORS LICENSE NO. TYPE STATE/ SIGNATURE OF APPLICANT DATE �G PERMITS/IMSP PAYMENT RECPT# 20407545 TOWN OF SOUTH WINDSOR 1540 SULLIVAN AVENUE SOUTH WINDSOR CT 06074 THIS IS NOT A PERMIT DATE: 05/12/10 TIME: 13 15 CLERK: dayshelll DEPT: CUSTOMER# 0 PARCEL: CHG: BLDPRM BUILDING PERMIT 45 00 AMOUNT PAID: 45 00 PAID BY: ANDREWS OIL COMPANY PAYMENT METH CHECK 4334 REFERENCE A104 WYNDEME AMT TENDERED: 45 00 AMT APPLIED: 45 00 CHANGE 00 THIS IS NOT A PERMIT THIS DOES NOT AUTHORIZE WORK TO BEGIN PERMIT CLOSED Electric # PER: PA 17-176 APE�CATION FOR BUILDING PERMIT Plumbing# AND Wyndemere Court q HVAC# rr_c 29�93 12000568 Date: /� Sprinkler# Estimated Cost $ FINAL APPROVALS Permit Fee $ �p S Building COMPLETE RED BOXED AREAS Occupancy Fee $ Engineering TYPE OR PRINT ONLY Eng. Insp. Fee $ Affidavit A r.forCO. ► SIGN ON REVERSE SIDE PP Total Fee $ 1� s TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby a plies to do work according to the following: Applicant Location of Work Lot No. Applicant's Address P, Tel # Town Zip Lic.# OG 0.2 SD$6 Owner AO- ,rl -P SW/Wl Architect Owner's Address U dr M c r CT Architect's Address So un" Sar tl__ Zip OG072 (I Zip Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area Purpose of this permit / �r o.^.U•t�! r� Pao/ �NKlr Al t e i Pv!T d.1S f 20", QaCKav,A i 4-S City Water❑ Well ❑ Septic System J Sewer❑ Ins: HO S Area Basement Garage Approved by Date10 '1s Use Group Construction Type a o is 0 ISZ 9 Rev,sw 1108 I hereby agree to conform to all the requirements of the Laws of the State of Connecticut and the Ordinances of the Town of South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of the Building for which this permit is asked,and agree that this building is to be located the proper distance from all street lines, side yard lines,and required distances from all other zones and is located in which this building and its use is allowed. Signed'fikl_e�./-Oe w I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed ot-/' vt-�--4v DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS