HomeMy WebLinkAbout204 WYNDEMERE CT BLDG 2 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR $Q61-1
BUILDING DEPARTMENT
APPR 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
Da a Building Inspect r
Application must be printed or typed
FEE SCHEDULE Location of Job:
F
Go"M ze- c� �$0-$1,000=$15.00 Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof nation Apt.No.
APPLICANT
APPLICANT ADDRE S
Gay �
APPLICANT PHONE# ?/
O W N S Fq OWNER
OWNER ADD SS /I
o OWNER PHONE
C = ESTIMATED COST$
IS THIS A CONTRACT COST? !/ es _No
o �G FEE ENCLOSED$
TYPE OF JOB:
�SOR•(10 New Installation
�Alteration/Addition/Repair
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE,OF SYSTEM: TYPE OF BUILDING:
044EATING RESIDENTIAL
❑ A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
❑HYDRONIC ❑WARM AIR ❑UNIT RADIANT HEATER
EXISTING RADIATIONZ�ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE —/O OF INSIDE IV OF DIFFERENCE °F
TOTAL HEAT LOSS(BTUHy (HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DES AL IPM'fE�NT(INCLUDING,bl-AKE&MOD�F NO
GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH)
TYPE OF FUEL
DIL—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 WORK f ��L2 G�/ �/_5.
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.
30 2 7717
CONTRACTORS LICENSE NO. TYPE iSTATE
SIGNATURE OF APPLICANT/ 2 DATE