HomeMy WebLinkAbout1115 MAIN ST DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: c6W 31 g
BUILDING DEPARTMENT
APPROV D 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
Date Building Inspect
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$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT I6
APPLICANT ADDRESS
?),-M(A 61-(c)k0 CT acc)I to
APPLICANT PHONE#
O W N S f,4 OWNER
OWNER ADDRESS 5
CT O10 0 r]q
Oo OWNER PHONES(o 0 0o 2K— 322 0
C ESTIMATED COST$ `7 n�
IS THIS A CONTRACT COST? Yes _No
o �(� FEE ENCLOSED$ ^]
O�� TYPE OF JOB: o`l �
OR•C New Installation
Alteration/Addition/Repair
}
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE QF SYSTEM: TYPE OF BUILDING:
EATING 'RESIDENTIAL
Cl A/C O COMMERCIAL
0 VENTILATION ❑INDUSTRIAL
HEATING
0 STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
❑HYDRONIC ❑WARM AIR O 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.)
GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
❑OEL--GPM OIL TANK LOCATION :0 INSIDEO 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 OFF SUCH WORK.
dd c �1
a 39 w�^/ L, C 1 T
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICCN�T DATE LF 0
-3F5H
Electric # APP ICATION FOR BUILDING PERMIT
Plumbing#
HVAC# w i 5 Date: — —19)
FINAL APPROVALS Estimated Cost $ c�
Permit Fee $ ,L,�„y� d —
Building /iu`VA!!�* COMPLETE RED BOXED AREAS Occupancy Fee $
Engineering TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit Appr.forCO. ► SIGN ON REVERSE SIDE -4
Total Fee $
TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $The undersigned hereby a lies to_do work according to the following: c/ q_I/) a
Applicant i / Location ofWork Lot No.
Applicant's Address, 3 U5 k L Tel # £�LaU 72. a 7 '� 7
Townes f.."Ae A l b /-2- �i Zip Lic.# D 5-�4,7 79'3
Owner O)- c R v ic t Architect
Owner's Address /(r`) & A i -1 Architect's Address
5 Lyl VQ& y k— Zip 0E>()-7 It Zip
Sq. Ft.New Area: 1 st A. 2nd FI. 3rd F Total New Area
Purpose of this permit
City Water J Well J Septic System ] Sewer 0
Ins: HO S rt Area Basement Garage
Approved by k Date ' >3. 1 Use Group Construction Type
? / -G / ^ ` devised 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 i ich this building and its use is allowed.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
INSPECTION FIELD SHEET 03/20/23
Printed by Middleton, Morgan 13 09 42
INSPECTION: 106496 FINAL PERMIT:
STATUS
APPLICATION: 201801201
LOC: 1115 MAIN STREET
SOUTH WINDSOR
PROPERTY ID: 54901115
OWNER: BANCROFT CAROLE
CONTRACTOR:
REQUEST BY:
PROJ DESC: REMOVE AND REPALCE ROOF
WORK ORDER:
INSPECTOR: WS-B RESULT: PASS
REQUESTED: PRIORITY:
SCHEDULED: COMPLETED: 03/20/23
UNPAID FEES 00 Date Time
MILEAGE: 00 TIME: TRAVEL ONSITE
COMMENTS:
INSPECTED BY VALERIE MUSZYNSKI
1800387 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER BUILDING PERMIT
DATE: 07/27/2018
GIS ID: 54901115 FEE: 180.00
MUNIS APPLICATION# 201801201 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: JULIEN'S ROOFING ADDRESS: A 115 MAIN STREET
ADDRESS: 453 FOSTER ST OWNER: `BANCROFT CAROLE
1117 MAIN ST
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: REMOVE AND REPALCE ROOF
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITII TI IE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE: 'f j insm,6—
OCCUPANCY GROUP: UIL OFFI AL
7/27/2018 1 1:43 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE