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HomeMy WebLinkAbout202 WYNDEMERE CT BLDG 2 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Z!APP-RO is herebTOWN OF SOUTH WINDSORBUILDING DEPARTMENT 1540 SULLIVAN AVENUE 644-2511 ext. 230 Bldg.Permit# Date wilding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: 2-c z w�.�al��t c�- $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT f�7�01/��✓1 O t �d APPLICANT ADDRESS l�G y-c �-�• �Q' . APPLICANT PHONE# O W N S c//F,q OWNER i .SG,y OWNER ADDRESS Z G?. GC/y/��j/P/,l e.,4-- G 7 �7` �G 617 Y a OWNER PHONE y3sl — O ESTIMATED COST$_��© el, C-0 IS THIS A CONTRACT COST? =Yes FEE ENCLOSED$ �6)® w 1� TYPE OF JOB: SO R C�� '—New Installation �� I _Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYST M: TYPE OF BUILDING: ATING ❑RESIDENTIAL 13 A/C ❑COMMERCIAL 0 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 HEATIN QUIPMENT(INCL ING MA &MODE NO.) �Z GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH) TYPE OF FUEL 3-0IL-GPM//-<OIL TANK LOCATION :O 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) / /7 FURTHER DESCRIPTION OF WORK(/r�G �4c�' idj d i ( �r/'L�� 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. Tyn STATE SIGNATURE OF APPLICANT TE II O�