HomeMy WebLinkAbout12 ORCHARD HILL DR APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OFF STEM: TYPE OF BUILDING:
V. 41EATING D-RESIDENTIAL
❑A/C 0 COMMERCIAL
❑VENTILATION 0 INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
4a'HYDRONIC ❑WARM AIR 0 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 EQUIPMEN (INCLUDING A�E&MODEL NO.)
Aao. !n 3 s���r� u� cd r � !'�6je f" 6V`7-r--0-3
GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH)/Cwd
TYPE OF/FUEL
l7 OIL—GPM 15 E` OIL TANK LOCATION :❑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 HAN1}-ING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
La-C '!Z /G+'L
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 OF SUCH WORK.
CONTRACTORS LICENSE NO. .TYPE STATE
SIGNATURE OF APPLICANT /� ' DATE r/ ��
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby: �by 3-7 rj
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
_ Lk-04 644-2511 ext. 230 Bldg.Permit#
Date / uilding Inspec
Application must be printed or typed
FEE SCHEDULE Location of Job:
7Designatlion
J A 111 b-/2 .
$0-$1,000=$15.00 StrStreet Lot No.
Over$1,000$15.00 per$1,000
or any fraction thereof Tenant Apt.No.
APPLICANT � lGl.✓S U r / l 4`
APPLICANT ADDRESS 126 -(t/C S'�. --5 elr�
7
APPLICANT PHONE# ! 0 )r �2 9-G 7G C
O W N S F,q OWNER l r K Gam-, �1J D e .K
OWNER ADDRESS
/t)i <<J S cn, C 0 6'0 7,yp
Ov OWNER PHONE A; Q
C = ESTIMATED COST$ -el Ole,, (j
b
IS THIS A CONTRACT COST? _Yes "o
FEE ENCLOSED$ 7S G
a.,
S . O TYPE OF JOB:
O R•C Zew Installation `v
_Alteration/Addition/Repair I ��
Revised 4/01//2002
a
CA )
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O
s9
70=
Eby '� �" �• �{' y' .6 . +� ..
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SuRVE
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Lots I F. 7 ane far,'
of AK `F C`.ZTAT:L
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing# PERMIT CI ospn Orchard Hill Drive Date:
HVAC #
Sprinkler# PER: PP�- 7-1? _Zh- -- _ ---
FINAL APPROVALS -- Estimated Cost $
Building COMPLETE RED BOXED AREAS Permit Fee $ 70,00
Engineering CG ?9-393 TYPE OR PRINT ONLY I Occupancy Fee $
Affidavit Eng. Insp. Fee $
A r. for CO.
► SIGN ON REVERSE SIDE J
PP I - ---- --- - - - -- -- -- - - _-� Total Fee $ 3d
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost)
The undersigned hereby applies to do work according to the following:
Applicant Location of Work /Z CrC AAw 12,111 Dn. Lot No.
Applicant's Address .9* _ Tel.# ?60 1-2 d'a 76�'
Towns,0v�� Id.�,Yfe � �� Zip 0,(C?Y Lic.# 3d 37&Z
Owner •, k Architect
Owr's Ad ress /2 C�� .r1 ��� D/L Architect's Address
-�c� l c Z;p Zip-
Sq. Ft. New Area: 1 st Ff. 2nd FI. 3rd Ff. Total New Area
Purpose of this permit -*-v Sf-e d", -.-C a•7 a < plc, •r ��f'� .
City Watero Well❑ Septic System❑ Sewer❑
Ins: HO SP L rt. Area Basement Garage
Approved by Date 14 Use Group Construction Type
Revised 6/02
I hereby agree ree to conform to all the requirements of the Laws of the State of Connecticut and the Owinances of the Town of
South Windsor and to notify the Building Inspector of any alteration in the plans or specifications of th.�Building for which this
permit is asked,and agree that this building is to be located the proper distance from all street lines,r,de yard lines,and required
distances from all other zones and is located in whi this building and Is se is allowed.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application foi the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Electric # APPLICATION FOR BUILDING PERMIT
Plumbing A 12 Orchard H111
HVAC# Date: �� 0 7
Sprinkler# SED 900404 Estimated Cost $
FINAL A -17 Permit Fee $ 10
Building ANr, COMPLETE RED BOXED AREAS Occupancy Fee $
Engineering CGS TYPE OF PRINT ONLY Eng. Ins . Fee $
Affidavit ► SIGN ON REVERSE SIDE � 01
Appr.forCO. Total Fee $ OT
TO THE BUILDING DEPARTMENT, TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant t i /,M LocationofWork D/Z LotNo.
Applicant's Address y�'„� IC4�5 T�,p 5 it- Tel # 3 /7 5—77
Town �- Zip c�e ? Lic.# (� 8
Owner r S eQ &olclk Architect
Owner's Address Z 6,/ie/7r4,eD Architect's Address
S. U� OS✓2. c L Zip Ve Q-7 Zip
Sq.Ft.New Area: 1 st FI. 2 d FI. 3rd FI. Total New Area
Purpose of this permit !PeK-Q.
City Water❑ Well ❑ Septic System 0 Sewer L1
Ins: HO SP Cert. Area Basement Garage
Approved by Date Use Group Construction Type
%Revised 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 o be located the proper distence from all street lines side yard lines,and required
distances from all other zones and is located which this bu:il:din�gs use is allowed.
Signed
I hereby apply for a Certificate ccupancy for the work described in this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS