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HomeMy WebLinkAbout205 GARDEN CIR Revised 4/01//2002 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is hereby: TOWN OF SOUTH WINDSOR U6 coy 9 BUILDING DEPARTMENT APPROVE 1540 SULLIVAN AVENUE Bldg.Permit# iG 644-2511 ext. 230 Dgte Building inspector Application must be printed or typed FEE SCHEDULE Location of Job: 05' C5A-Qk q N (A $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS k �`� APPLICANT PHONE# 1%O W N S F-4 OWNER �1 OWNER ADDRESS a Ca OWNER PHONE 4C, C ESTIMATED COST$ c��Cn©C) IS THIS A CONTRACT COST? Yes _No o nq... FEE ENCLOSED$ `I S O�� TYPE OF JOB: (� OR-Co _New Installation Alteration/Addition/Repair APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF PUILDING: EATING SIDENTIAL- ❑A/C ❑COMMERCIAL ❑VENTILATION ❑INDUSTRIAL HEAT ING ❑'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) °F(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INC)LUDING MAKE-84M DEL N .) Q GROSS HEATING CAPACITY(INPUT—BTUH) NET RATING(OUTPUT—BTUH) ?vOlooc� TYPE OF FUEL XG❑ L—GPM OIL TANK LOCATION :❑ INSIDE❑ OUTSIDE CAPACITY S—INPU 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 o0 5 (�^� r1 �5g(Yvi�� c (c�c ep,_ 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. 3cl wa; D CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT E TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER HVAC PERMIT DATE: 02/08/12 GIS ID:34600205 FEE: 45.00 MUNIS APPLICATION# 201200107 BUILDING DESCRIPTION: APPLICANT LOCATION NAME: GLASTONBURY FURNACE`&FIREPLACE ADDRESS: 205 GARDEN CIRCLE ADDRESS: 133 TALCOTT ROAD OWNER: STOUGHTON ALFRED G&RUTH W GLASTONBURY,CT 06033 _205 GARDEN CIRCLE SOUTH WINDSO,CT 06074 DESCRIPTION OF WORK: VENT FREE NATURAL GAS STOVE. GAS LINE IN BASEMENT TO STOVE ON FIRST FLOOR SPECIAL CONDITIONS: h ALL WORK TO BE DONE IN ACCORDANCE WITH THE APPLICATION AND PLANS APPROVED BY THE BUILDING DEPARTMENT. CONSTRUCTION TYPE: OCCUPANCY GROUP: µ BUILDING OFFICIAL 2/8/2012 9:38 AM THE FEE ABOVE INCLUDES A$0.26 PER THOUSAND CT STATE EDUCATION SURCHARGE