HomeMy WebLinkAbout110 IDENT RD DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Applicati TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
P 1540 SULLIVAN AVENUE
Bldg.Permit#
644-2511 ext. 230
Date ding 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$1,000
or any fraction thereof Tenant Designation Apt.No.
I J
APPLICANT'JZ�7
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APPLICANT DRESS
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APPLICANT PHONE# 3
OWNER
W SF
N q
OWNER ADDRESS
a OWNER PHONE
C ESTIMATED COST$ S®f�
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IS THIS A CONTRACT COST? -fes _No
FEE ENCLOSED$
1��s O�� TYPE OF JOB:
�R C New Installation
al—on/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMI (Continued from reverse side)
TYPE OF SY M: TYPE OF DING:
EATING SIDENTIAL
❑A/C 0 COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑STEAW LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
PlftRONIC ❑WARM AIR ❑UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE _°F INSIDE �2d _°F DIFFERENCE:2°F
TOTAL HEAT LOSS(BTUH)Y? 3d°F(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
GROSS HEATING CAPACITY(INPUT—BTUH)4QOL NET RATING(OUTPUT—BTUHy�O�i
TYPE OF FUEL
QAxrLr-GPM,i 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 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 jprj
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.
30 2 ?7 3 s1� Cam;
CONTRACTORS LICENSE NO. TYPE STATE
i
SIGNATURE OF APPLICANT DATE
t H E A T L O S S Berkeley Heights. ,079 N 22 ;
Customer _ Telephone _. Dalo
t
Name Address Y .et — --)0. (�r-j.!SJ �- _..
Heat Loss Calculated By Btuli per loot of Baseboard:
-- at Average Water Ten►p: %,J✓
Design Temperature: Room Room: Roont: Room: Rom;
Difference: % �^ i [��
Line Factor Len Ih Width lies phi Btuh Len Ih 1Ydth lici ht Btu ten Ih Width HciRht Dtuh Lcneth Wir Ih IleiRht ptuh Len III Wit his Itciciu DluI
1. INFILTRATION VOLUME 1 JZ '' 1 2 ] 1 2 ] 1 2 3 i 2 ] 7 2 3
Hurubcs of outside walls 2,y
with openings(L x W x 111 �� �� l�r 5� e
l,��j
2 CEILING AREA q '- - ROC
(LxW) !3� /I� [Or.
(✓/ FRC
1 FLOOR AREA(L x W) LIN
or SLAB(lineal feet
exposed edge length)
4. COLD PARTITION AREA
(partition L x H)
S. WINDOWS OR DOORS
(i EXPOSED WALL AREA
(exposed L x H)
7. OPENINGS StI.h.d so.It. vt.It. _tit.It t• sa. -
ine S faor minus 11.
line
�� 6�� --
line 6 factor
f TOTAL Bluh
pascboarJ Lcn Ih (l. It. II.
Dilleience; (Add 2VX.for Bajhrooins)
Design Tcmperaturc: Dom: `;'' Room: Root„: Run in: Room;
� -
Line Factor length Width I lei Ohl Dtuh Length Width jt!fih I Bw Lcn rh Width I lei M Diuh Length Width I lr•.iglri ptu i LcnCtlr 1Nirp IIci�1.i pluh
I. INFILTRATION VOLUME 1 1 2 3 1 2 3 1 2 3 1 2 ] 1 23
Number of outside walls 2
with openings(L x W x Fi) 3
Z. CEILING AREA
(L x IN) t
i FLOOR AREA(L x 1N) TOTA
or SLAB(lineal feel OF BUI
exposed ed a len III I ATi)1
4. COLD PARTITION AREA TEAIPEI
(partition L x N) DIFFEI
S. WINDOWS OR DOORS
6. EXPOSED WALL AREA it
(exposed L x H)
7. OPENINGSsn.ft.
(line 5 factor minus It sq.ft. sa.h
fine 6 factor
B.TOTAL Blob
Baseboard length It. h. Ir h It
t
PRIMUS & WELTI ENGINEERS
Glostonbusy, Conn.
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FGJNDATIO t CNE KED
DATE / I .
w' SCALE, CERTIFIED SUBSTANTIALLY CORRECT
SIGNED C , (� t�L• •••v DATE /O ��-g /S SIGHED �"
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