HomeMy WebLinkAbout108 OLD FARM RD APPLICATION FOR HVAC PERMIT
DEPARTMENT DECISION TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: BUILDING DEPARTMENT 1 (pn o l i y
APP 0 1540 SULLIVAN AVENUE Bldg.Permit#
. 644-2511 ext. 230
Date Building
Application mast be printed or typed
FEE SCHEDULE Location of Job:
$041,000=$15.00 !.g 5
Over$1,000= Street No. Street Lot No.
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt,No.
APPLICANT
APPLICANT ADDRESS 41 ill
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APPLICANT'S PHONE# - Q
OWNER G., f1Vtc'
�OVi N S Eq< OWNER ADDRESS /D OZZ9 yt�r ys
OWNER PHONE v U 9
Ca ESTIMATED COST$ -5 70f
(� IS THIS A CONTRACT COST? -- Yes No
FEE ENCLOSED$ q0 ,
° ° �` TYPE OF JOB: J�J
SQ1I.Co N Installation
Alteration/Addition/Repair
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Revised 03/05/10 .
APPLICATION FOR HVAC PERMIT(Continued from reverse side)
TYPE O"YSTEM: TYPE OF BUILDING:
[a PEATING C'RESIDENTIAL
51"A/C ❑ COMMERCIAL
❑ VENTILATION ❑ INDUSTRIAL
HEATING
❑ STEAM LOW PRES URE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
❑ HYDRONIC WWARM 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)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
�OODf9/9ifJ %6 G� �l/`PC 7� l/F'N
GROSS HEATING CAPACITY(INPUTBTUB[)��OCU NET RATING(OUTPUT-BTUH)
TYPE OF FUEL
❑ OIL-GPM OIL TANK LOCATION: ❑ INSIDE ❑ OUTSIDE CAPACITY
Q--G-AS-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 UDING MAKE&MODEL NO.)
5---
TONNAGE COOLING CAPACITY(BTUH)3G,d OG
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 HEREBYAPPLIES 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
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1600114 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER HVAC PERMIT
DATE: 04/04/2016
GIS ID:66300108 FEE: 90.00
MUNIS APPLICATION# 201600279 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: QUIET CORNERS MECHANICAL LLC. ADDRESS: 108 OLD FARM ROAD
ADDRESS: 118 PARISH HILL ROAD OWNER: CLYMER RONALD L&DEBRAH K
N WINDHAM,CT 06256 108 OLD FARM ROAD
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: INSTALLING A DIRECT VENT FURNACE AND REPLACE A/C UNIT.
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
4/4/2016 2:29 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE