HomeMy WebLinkAbout11 HERMAN WAY Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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**-31328-B 2,999
PO4 GAS TEST O1/10/05 PJP D PRESSURE TEST GOOD,CHIMNEY SLEEV
ED 411VENT &
3" INTAKE,REMOVE GAS LINE FROM F
LUE TO WOODST
PO4 GAS TEST O1/13/05 PJP A GAS LINE RELOCATED,PRESSURE TEST
GOOD,VIDEO
TO BE DONE OF FLUE REPAIR TO PEN
ETRATION
**-12412-H 600
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 bcated the proper distance from all street lines,side yard lines,and required
distances from all other zones and is located in which his building and its use is allowed.
Signed r/••P
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW Ti-iiS�iNE
INSPECTION COMMENTS
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# 11 Herman' s Way Date:
HVAC # i�`I�
Sprinkler#
FINAL APPROVALS - - �- - - _ Estimated Cost $ - 'i
Building - - --- -- - -- - Permit Fee $� — -
- COMPLETE RED BOXED AREAS I Occupancy" $ �
Engineering TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit SIGN ON REVERSE SIDE
Appr. for CO. Total Fee $_�_
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ -?--2
The undersigned hereby applies to do work according to the following:
Applicant w'f S%bK STA 44Ci _Location of Workyj-�krM.ly� '�''' Lot No.
Applicant's Add ressaO ut4tr Zi�AZ J-&AJ -iA4 ,5- ef#_ T � 6 ZJ'- S_2
Town Zip Lic. #_,5�2 g Z 7
Owner Z r D C7 A-- Architect
Owner's Address // VE Q6nAA1 ul,^y Architect's Address
Zip Zip
Sq. Ft. New Area: 1 st FI. _ 2nd FI. 3rd Fl. Total New Area
Purpose of this permit-/N 3 $ ^A GAS 7y4Zr3 i i...,4r /,%J S ts"Z i* 70 �-
1ZI Le cc
City Watero Well❑ Septic Systemo Sewero
Ins: HO P Cert. Area Basement Garage
Approved y Date)I l o4,f Use Group_ Construction Type
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DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
Applica eby:
TOWN OF SOUTH WINDSOR PERMIT#
' �
BUILDING DEPARTMENT
APPRO V 1540 SULLIVAN AVENUE Bldg. Permit#
@ ;j i "� 644-2511 ext. 230
Date Building Ins for (3
Application must be printed or typed
FEE SCHEDULE Lo t107 of Job:
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
t � APPLICANT Ci L�iJv,s�
APPLICANT ADrSS -ewC
S U�L(
APPLICANT PHONE#
OWN 3 F,q OWNER
OWNER ADDRESS
OOWNER PHONE
C ESTIMATED COST$
IS THIS A CONTRACT COST? 'CYes _No
FEE ENCLOSED$
bS O�� TYPE OF JOB:
OR.C New Installation
-�f—Alteration/Addition/Repair
ReviceA 4101//70f17
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF BUILDING:
❑HEATING ❑RESIDENTIAL
❑A/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 °F INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS (BTUH) OF(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 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)
NS MU�OFWO
COMPANY APPLICATION)
FURTHER D'=SCRIPTION
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.
3� G 3
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT DATE