HomeMy WebLinkAbout1216 MAIN ST DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Application is hereby:
BUILDING DEPARTMENT
APPROVED 1540 SULLIVAN AVENUE
Bldg.Permit#
644-2511 ext. 230
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE Location of Job:
Z � 10 C�'l O. �� q�
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000 _
or any fraction thereof Tenant Designation Apt. No.
APPLICANT
APPLICANT ADDRESS -- -
APPLICANT PHONE#
O W N S F,q OWNER
OWNER ADDRESS \2
5 L.1 1
Or OWNER PHONE 2 CA,\- c \5
r
C ESTIMATED COST$ --r4 111 J
xIS THIS A CONTRACT COST? ' Yea _No
FEE ENCLOSED$ Qv
SO TYPE OF JOB: /
R C _New Installation •/' .
✓Alteration/Addition/Repair
Revised 4/01//2002 ?�
APPLICATION FOR HVAC PERNHT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF BUILDING:
HEATING RESIDENTIAL
'U 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 OF INSIDE OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.)
•fit,.\\ \
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)
(PLANS MUST ACCOMPANY APPLICATION)
FURTHER DESCRIPTION OF WORKe\��
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.
Ck
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT ��� `.ram,Q ����,���_ DATE
T
N
W �
3a
PROPERTY OF
WILL !AM T. FIR A IZEs
SUSAN W. FRAIZE
MAIN STREET
SOUTH WINDSOR, CONN.
SCALE;I INCH 40 FEET NoVEMBER, 1971
C5--;j A
SAMUEL A WILLARD
PIN s 310- 03,-5d,V., i.plN
170.55
DEED
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LPIN 174 3 2' I.Pl N
213-14' TOC.C.H.D. HIGHWAY NSI'-'-09'-00" E LINE 395.5'TO GOVERNOWS
ON. HIGHWAY
kj _7 I'
M AIN STREET*
36-107 V.9.4 0-3 2
D
>�16 � 1990
South Windsor
BUILDING DEPARTMENT
CO T1* WiDti16 Dui. ,
This certified that this plan and spcclfio lions rs,r
copies of the proposed building or alterations to 6
erected Jat
/L!z ''`4 r� etre
together with amendments stated in application r
filed with plan and I agree to comply with all zonin
6ullding and state laws and such orders as &hall I
issued by the Ou' inq Department durir.,; �pen-' �
'I this appli and 4"1 Issuance
permit.
4 ,/ , /
.ipproved sublet to tb* condAsaw -.
\ rdlwaooes rewletied bkdk rrs strap be
. fbam Pited Wibfi
4::34;,Qs:Wo 4 ,%C-loa/kk
�Q
CERTIFICATION OF ZONING C0IGIPLIAi'+CE
Proposed bullding(s), use(s) and/or structure(s)
as shown oR this plan appear(s) to be in
�a X 26 conformance with current South Windsor
;zlrations. Variances and special exceptions
apply.
Date �� f
n g Enforcement Officer
i
• m��rl.JF" ". . � 3 4,�,
PROPERTY OFx *' � '�
�'a Yr���c •�•!vl` �.f, _ '; '� !:.°"' "r cam, t F�'�� �' ��i �{ �'
Y ' ` SUSAN
FRA/ZE
ram ! MAIN STREET
Q
' �� . SOUTH ; WAN OSOR, CONN.
SCALE-. I INCH 40 FEET NOVEMBER,
Y tZQ,t tiZy ;t;'s mapI) be Substantial'
�► ._ � .4 correct and in accordance w i L", Clasp A-2
a• °za of Code of Cot:n.. Technical Council
I � `
SAMUEL A. WILLARD
� .
S 3I°- 03'-50°W I.PIN —
1T0 5555 -
DEED
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4� J
J Q
O t
O_ 16 Q
M 0 -
Q OM M O M O Q �F
d.
cV N N W
ry
•► F g T�
F R Y '
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213.14 TO C.H.D. HIGHWAY 3, I•PIN
;xk. p�yW MON. N31a-0 0"L — LINE 3955,To oovEPIN011
� �� � d�01-" ' ' ►HiNwAr —i
y
MAIN STREET' " ,
f.i.40-323
Electric# APPLICATION FOR BUILDING PERMIT
Plumbing# 1216 Main Street Date:��
Sprinkler# 32410
FINALMI
- Estimated Cost $ %t'.
Buildin700�0' SI�GN
— -- — -- Permit Fee $
`"�`1PLETE RED BOXED AREAS I Occupancy Fee $
Enginee n �\// TYPE OR PRINT ONLY Eng. Insp. Fee $
Affidavit ON REVERSE SIDEAppr. for CO. _ - -_ — Total Fee $
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant ol—r ICK Tr) Location of Work 191,44 4 At,r Lot No.
Applicant's Address i 1 el.#
Town 1 Zip Lic.#
Owner Architect
Owner's Address I I k1 Architect's Address
Zip Zip
Sq. Ft. New Area: 1 st Fl. 2nd FI. 3rd FI. —Total New Area
Purpose of this permit�e t V1 GCL
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO SP Cert. Area Basement Garage
,, 71�t�k - Use Group_-- -0anstruc
Approved by Date don Type
41.1 Revised 6/02
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 in which this building and its use is allowed.
Signed
1 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 / Approval Date By Appl
Code Description Due Whom Code Comment
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**-32410-B 1,000
B10 FINAL 04/18/07 JFF A
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