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HomeMy WebLinkAbout16 RAVINE RD Revised 4/01//2002 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: BUILDING DEPARTMENT AP ROV 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date Bu' ng Inspector Application must be printed or typed FEE SCHEDULE Location of Job: f $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT { n 1 (j�n.% APPLICANT ADDRESS CT 0(Do") 4 APPLICANT PHONE# 0W N Si , OWNER C�n d�i� Hea.(•.t OWNER ADDRESS 5- W rlol SO! C- o OWNER PHONE 7�(aC7 S23 �Z o0�7 C C = ESTIMATED COST$ 'b 1000- w * IS THIS A CONTRACT COST? Yes No FEE ENCLOSED$ TYPE OF JOB: -�-) /Z SOR.CO New Installation —Alteration/Addition/Repair l a 0 ()q w g APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: ❑ HEATING CKRESIDENTIAL ❑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.) 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 L Q S 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 Se i 1 Z S q A l -4 c,�%L r )•A c s q rl c� n �A ►Ct�� (u, 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. E-ITC-,0-4 01110 CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT kJ"'" ; DATE >.1,•Ii� +V i, �•,, _ tTtr 91rr� 1,ii,g` , a��Sl ". ,. ' :ls': •'t:t:}• { _ , a¢�'. SS 'fi4 f r'a 5,, r? �.� \li;-4t a� r�rr{r ti ��ll. "�'� "Il�+ + ! �, ! 1 •` /' a ��1\da., :!�il:/�� y� `� L{�� )r if 1,,(.� �, ��\�1�J,��•, '` �A' ')� ��j/ �'�: i ry�j� � t - 7i .'f '' ,'�, �`7 t+` ..t�. �• .1Yy3yn �?r,+f�w`'. 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''![ ,>u ,err � ,. y� , __ .,�.,, �.R�. f' '•1' gy�pp,, ��,yr .W���� '� ^r'• '' .iy� '�,. t ••j•' � �•�•�` irk•/ •:F •t � iry } , ,, I rf,••4 �, .l',r�I c •t� l ' I f \ y�£',•',.f � `iJ �! ,' �,, .•� �sj w f�yy. ± � �yj�y.I'jy��� 1� �r •: , 1200285 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER HVAC PERMIT DATE: 07/31/12 GIS ID:75000016 FEE: 15.00 MUNIS APPLICATION# 201200968 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: PROPANE GAS SERVICE ADDRESS: 16 RAVINE ROAD ADDRESS: P.O. BOX 880 OWNER: HEALEY CYNTHIA SOUTH WINDSOR,CT 06074 16 RAVINE ROAD SOUTH WINDSOR,CT 06074 DESCRIPTION OF WORK: SET 125 GALLON TANK,RUN LINES,AND INSTALL GAS LOG. 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 7/31/2012 3:09 PM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE