HomeMy WebLinkAbout15 GRACE RD DEPARTMENT DECISION L APPLICATION
fJ� APPL N FOR HVAC PERMIT
C O
1_ TOWN OF SOUTH WINDSOR PERMIT#&56�9
ApplicTiy: BUILDING DEPARTMENTAP 1540 SULLIVAN AVENUE Bldg.Permit#
� 644-2511 ext. 230
Date or
Application must be printed or typed
Location of Job:
FEE SCHEDULE
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt. No.
APPLICANT --L rm < Ca
APPLICANT ADDRESS t
s w �
APPLICANT PHONE#
OWN SF
F,q OWNER
4 OWNER ADDRESS
S w
CCr« E,,, OWNER PHONE u C ESTIMATED COST$ Ooc�
IS THIS A CONTRACT �, s✓ Ye No
vo
0 FEE ENCLOSED$
1��5 - O�� TYPE OF JOB:
O R C New Installation l
✓Alteration/Addition/Repair
Revised 4/01//2002
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF YSTEM: TYPE OF BUILDING:
HEATING RESIDENTIAL
A/C COMMERCIAL
❑VENTILATION ❑ INDUSTRIAL
HEATING
0 STEAM LOW PRESSURE LFAIT LBS. HIGH PRESSURE LIMIT LBS.
V HYDRONIC ❑WARM AlR ❑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)
l ` \ DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE MODEL NO.)
W e\ — t'�`Cl L to h V.r� 60-U1 c c.0--t' \C ON 0\\Q.f
GROSS HEATING CAPACITY(INPUT—BTUB) 14 S NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
0 OIL--GPM 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 HANDLING EQUIPMENT(INCLUDING KITCHEN EXHAUST EQUIPMENT)
TOTAL SIZE OF SYSTEM(CFM) FRESH AIR INTAKE(CFM)
(PLANS MUST ACCOMPANY APPLICATION)
FURTHER DESCRIPTION OF WORK \\
O\\t C C h c.,n�.C 4��c�
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.
.2 U ':� S Ck R S— 3
CONTRACTORS LICENSE NO. TYPE n STATE
SIGNATURE OF APPLICANT �.q,,��� ��_ �-� Tt DATE vk/
,
Electric # APPLICATION FOR BUILDING PERMIT
VSprPA
15 Grace RoadDate:
17-176 10 0 0 3 0 5 Estimated Cost $
FINA)kIffROVALS Permit Fee $
Buili COMPLETE RED BOXED AREAS Occupancy Fee $
Engine TYPE OF PRINT ONLY Eng. Insp. Fee $
Affidavit ► SIGN ON REVERSE SIDE t
Appr.forCO. Total Fee �$ /oea
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 eel t No.
Applicant's Address Tel #
Town Zip Lic.#
Owner S Architect
Owner's Address tiArchitect's Address
sdT Zip T . &q q- 10 d Zip
Sq. Ft.New Area: 1 st A. 2nd A. 3rd FI. Total New Area
Purpose of this permit re
City Water❑ Well ❑ Septic System ❑ Sewer❑
Ins: HO SP C Area Basement Garage
Approved by ` 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 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. r/
jSigned
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
1000305 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER BUILDING PERMIT
DATE: 06/30/10
GIS ID:37200015 FEE: 105.00
MUNIS APPLICATION# 201000805 BUILDING DESCRIPTION:
APPLICANT LOCATION
NAME: NADEAU RONALD J ADDRESS: 15 GRACE ROAD
ADDRESS: 225 SOUTH MAIN STREET LOT 20 OWNER: ANDRUS MARCIA T
EAST WINDSOR,CT 06088 15 GRACE ROAD
SOUTH WINDSOR,CT 06074
DESCRIPTION OF WORK: REMOVE AND REPLACE
SPECIAL CONDITIONS:
ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT.
CONSTRUCTION TYPE:
OCCUPANCY GROUP: BUILDING OFFICIAL
6/30/2010 9:34 AM THE FEE ABOVE INCLUDES A$0.22 PER THOUSAND CT STATE EDUCATION SURCHARGE