HomeMy WebLinkAbout2304 ELLINGTON RD DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
TOWN OF SOUTH WINDSOR PERMIT#
Applicati � by:
BUILDING DEPARTMENT —
1540 SULLIVAN AVENUE Bldg.Permit#
t_'131 fl 0 644-2511 ext. 230
Date Bu ing Inspector
Application must be printed or typed
FEE SCHEDULE FtTenant
Loc ion of Job:$0-$1,000=$15.00 Street Lot No.
Over$1,000$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT
APPLICW ADqRES
� -
APPLICANT PH NE# �l
W OWNER Ups
O N 3 Fq
OWNER ADPRESS
C*0 OWNER PHONE 7 p
C ESTIMATED COST$ �Od
�.� IS THIS A CONTRACT COST? Y—Yes _No
o r �� FEE ENCLOSED$
TYPE OF JOB: 19'A 31 '
dSOR,Cps '
_New Installation vv�5
� teration/Addition/Repair
49
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE.OF SYSTEM: TYPE OF BUILDING:
p4trATING ❑RESIDENTIAL
❑A/C ❑COMMERCIAL
❑VENTILATION ❑INDUSTRIAL
HEATING
❑ STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS.
DRONIC ❑WARM AIR ❑ UNIT RADIANT HEATER
EXISTING RADIATION ADDITIONAL RADIATION TOTAL RADIATION
DESIGN TEMP. OUTSIDE O°F INSIDE �OF DIFFERENCE OF
TOTAL HEAT LOSS(BTUH4 (HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
VDES RIBE L HEATING E UIPM T INCL ING MAO MODEL ONO.) �
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 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
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.
-7
CONTRACTORS LICENSE NO. TYPE STATE
SIGNATURE OF APPLICANT ` DATE / -fig
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Building Information Rooms
Name Donald Berghuis Click on room label to edit
Location 2304 Ellington Label Exterior height floor
Road Wall sq. ft.
Length
Upper design 91 main 160 8 1400
temp. house
Lower design -10
temp.
Add a New Room
Room temp. 71
Leeway as % 10
Number of people 5@400
Ground temp. 50
Cooling air 50
Warming air 120
Change Information
Calculation
Building Rooms
Gain BTU 18667 Label Gain Gain Loss Loss Base
Loss BTU 85424 BTU CFM BTU CFM Board
Gain CMF 623 main 16667 556 85424 1614 148
house
Loss CFM 1614
Base Board 148
Tonnage EK]
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http://webbconnect.fwwebb.comfbin/f wk?wc.hc.room.process 11/29/2007
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111nElectfic # (�2�`�. 1 Eeo
�I�1 1A OR BUILDING PERMIT
� � � d
Plumbing# l . y�ono u 3 0008 Date: Y/L�d
HVAC #
Sprinkler# Souu vvuiasor
FINALT
RO nihi L�iTI Estimated Cost $ 30
Building ��""'� E RED BOXED AREASPermit Fee $
Enginee TYPE OR PRINT ONLY Occupancy Fee $
Eng. Insp. Fee $
Affidavitppr. for CO. ► SIGN ON REVERSE SIDE / Total Fee $
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant zt^ As d de-^+1-j 2 tom ,^s Location of Work Lot No.
Applicant's Address %D S �d4.�^ Tel.# .2 -1(.6 3
Town S�+� G'�%�s°� Zip pb,-y Lic.#
Owner Architect
Owner's Address )_id Fjt,'^,1+1 Architect's Address
Stl Zip Zip
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit G,- o« e ifs'- 1, ( 4 r I _(Q_II(c) o n k«lc o 4-- k,14
�K,t+ll i�c f wok" S4,,'Clto alfT r; 4,
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO Isff Area Basement Garage
Approved by A
! Use Group Construction Type
Revised 6102
1�
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.
Signed
I hereby apply for a Certificate of Occupancy for the work described in this application for the permit.
Signed Y'
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
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=roposcd building(s), use(s) and,''cr st,uctur:.',;'
shown on this plan app'�ris) t he
�nformance wish current S�;Ith
gulations. Variances and spacial �xC�
,ay apply. I
:ate
Electric # FG 5 7 APPLICATION FOR BUILDING PERMIT
Plumbing# [Tate:Z6 3/ ' Q-11�
HVAC # 2304 Ellington Road
Sprinkler# 2 9 2 6 0 c.a
FIN P - - - _- __ - -- Estimated Cost $ ` -
Buildin ' 06 « FTYPE
PLETE RED BOXED AREAS Permit Fee $ y1y
Enginee ' Occupancy Fee $ /d
Affidavit OR PRINT ONLY Eng. Insp. Fee $
Appr. for C o ON REVERSE SIDE- --- Total Fee $
TO THE B I DING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant dd., Location of Work J'vt� f��^�' .-- D�� ,� �F/��cl✓t No.
T
Applicant's Address .ar E Tel.#fi6o—s`a,-
Town e, c/ e`7/ Zip i Lic.# D �k
Owner -v- Lvc Architect - 6
Owners Address �-� /j i Architect's Address
✓� Zip Zip
Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area xKorV
Purpose of this permit
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO SP Cert. Area Basement Garage
Approved by Date &I Use Group Construction Type
Revised W02
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 afterabon 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 building and its use is
Sign
I hereby apply for a Certificate of Occu nc for the work described in this for the permit.
r
Sign
DO NOT RITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-29260-B 28,000
B01 FOOTING 11/05/02 CJD A
B03 FRAMING (ROUGH) 11/15/02 WNB A FIRE SEPERATION NEEDED,LAM SPECS
NEEDED
WITH CONTRACTOR
E03 ROUGH 11/15/02 WNB A WITH CONTRACTOR
B10 FINAL 03/23/05 JFF D WITH OWNER DEFECTIVE GFCI DOOR C
LOSER
B10 FINAL 06/22/05 JFF D WITH OWNER CONTRACTOR TO COMPLET
E WORK THIS W
WEEK AND CALL
B10 FINAL 02/02/06 JFF D N/A DOOR TAG
B10 FINAL 02/03/06 JFF A WITH OWNER
**-18057-E 400
J
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
TOWN OF SOUTH WINDSOR PIT#
ERI
Application is hereby: 1
BUILDING DEPARTMENT
APPROVED, 1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg. Permit#
Date Building Inspector
Application must be printed or typed
FEE SCHEDULE 4, Location of Job:
2 3 o y 'El"ll rrl &,
$0-$1,000=$15.00 Street No. Street Lot No.
Over$1,000=
$15.00 per$1,000
or any fraction thereof Tenant Designation Apt.No.
APPLICANT --E)kU— 6�OgA—
APPLICANT ADDRESS 7
APPLICANT PHONE# �% o 8 7 Z- 1�Z o Z
0 W N S F,q OWNER -�Da-) L-� l V 'BE���T La t
OWNER ADDRESS 2 3 c0
.� =,c J r � I2, Cf 7 Y
�'' OWNER PHONE �G a 64� ( 'Yy
0
C ' ESTIMATED COST$ / ;?—UD , 0
.� IS THIS A CONTRACT COST? ✓ Yes _No
4 �G FEE ENCLOSED$ :�;6 6d
5O. '�0�� TYPE OF JOB: 33
R _New Installation
,AL Alteration/Addition/Repair
Revised 4i0 vrzoo2
APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side)
TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A
BUILDING PERMIT APPLICATION? Cl YES ❑NO
❑RESIDENTIAL
❑BUSINESS CURRENT USE AND OCCUPANCY
❑ASSEMBLY
❑MERCANTILE FUTURE USE AND OCCUPANCY
❑EDUCATIONAL
❑INSTITUTIONAL
❑FACTORY ENGINEER'S NAME PHONE
❑ STORAGE
❑GARAGE ADDRESS
❑MIXED USE
(Other please specify) CITY STATE ZIP
TYPE OF INSTALLATIONIWIRING METHOD
SIZE OF SERVICE ZCTD 4— SIZE OF MAIN CONDUCTORS
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS— 7 REMOTE DISCONNECT REQUIRED? ❑YES KNO
NUMBER OF LIGHT CIRCUITS NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES NUMBER OF HEAT CIRCUITS
NUMBER OF A/C CIRCUITS
SEPARATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
Ic
S re (.ocA-4- nn a 1 C( uR etc•-� 4,-y 2y-b 4-n e
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. TYPE STATE
SIGNATURE OF APPLICANT DATE r7 2G
TOWN OF SOUTH WINDSOR
AFFIDAVIT OF ACTUAL COSTS
PERMIT NO: DATE Z:.G (� a
Tlie undersigned,being a duly authorized representative of,_ 3c ll �emo�c` �� c 'i
do by this statement, certify that the actual.costs shown below, of the project referenced by the Permit
Number shown above,are true and accurate.
This statement is being made pursuant.to the Town of South Windsor-Ordinance,Article il, Section 14-31,
(a)thru(e),(see attached).
I understand that verification for accuracy of actual costs may be made at any time by the Building Official
through an appralsat of the work at the expense of the property owner.
hereby certify that the'actuai cost of the work performed under this permit is:
Stoy,oy
Signature of Permit Holder.
Name(Please Print)
-Date: (�
I
rrrrrrrrrsrrrrrrrrrrrraarrrrrrrrrrrrrrrrsrrrrrrrrrrrrarrrrrrrrrrrrrrrr*rrrr�rrrr■
State'of Connecticut]
County of Hartford] ] ss South Windsor Date:
Personally appeared as aforesaid,
Signer and sealer of the foregoing instrument and acknowledged'the same to be
his/her free act and deed, before me.
Notary Public
Commissioner of the Superior Court
My commission expires on
Ele^tric# -.fir APPLICATION FOR BUILDING PERMIT
Plumbing# 2304 Ellington RoadDate:
HVAC #
Sprinkler# �0 QJ 6 0
FINAL APPROVALS — �-__ -- --- - —----- -- ----� Estimated Cost $��
Building COMPLETE RED BOXED AREAS Permit Fee $ 30
Engineering TYPE OR PRINT ONLY I Occupancy Fee $
Affidavit REVERSE SIDE SIGN ON REV Eng. Insp. Fee $
Appr. for CO. Total Fee $ 11)
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant ✓ C Location of Work Q Lot No.
Applicant's Ad dress Tel.# L I
Town � � C Zip DGOZa Lic.# C Z1
Owner -t—Utcjklml, Architect
Owner's Address Architect's Address
Zip Zip_
Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area
Purpose of this permit_ C. ,�T!'f I,T S f i".A Mtn 0(
City Waterk Well❑ Septic System❑ Sewer
Ins: HO SP Cert. Area Basement Garage
Approved by Date Use Group Construction Type
Revised W02
11 G lv
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 looted the roper distance f mall street lines,side yard lines,and required
distances from all other zones and is located in whi is bui Y
d it a II ed.
Signed
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
TOWN OF SOUTH WINDSOR
AFFIDAVIT OF ACTUAL COSTS
PERMIT NO: D 6 7� DATE 3 13 loq
J.
The undersigned,being a duly authorized representative of, C LTI C.oin,S; t-Qyi L bC
do by this statement, certify that the actual costs shown below, of the project referenced by the Permit
Number shown above,are true and accurate.
This statement is being made pursuant to the Town of South Windsor Ordinance, Article 11, Section 14-31,
(a)thru(e), (see attached).
I understand that verification for accuracy of actual costs may be made at any time by the Building Official
through an appraisal of the work at the expense of the property owner.
hereby certify that the actual cost of the work performed under this permit is:
$ 2Z o0
Signature of Permit Holder: VY W1f4;;7f
Name(Please Print) Ci f J p_S L H Vt 1;4(�VA
Date: 3 3 1 0
.................................................................................
State of Connecticut]
] ss South Windsor Date:
County of Hartford]
Personally appeared , as aforesaid,
Signer and sealer of the foregoing instrument and acknowledged 'the same to be
his/her free act and deed, before me.
Notary Public
Commissioner of the Superior Court
My commission expires on
INSPECTION FIELD SHEET 02/03/21
Printed by Middleton, Morgan 10 05 57
INSPECTION: 22884 OTHER PERMIT:
STATUS
APPLICATION: 200900260
LOC: 2304 ELLINGTON ROAD
SOUTH WINDSOR
PROPERTY ID: 30302304
OWNER: BERGHUIS DONALD W & LUCY A
CONTRACTOR: CLH CONSTRUCTION LLC
860-888-2166
REQUEST BY:
PROD DESC: STRIP ROOF AND REROOF, STRIP SIDING AND RESIDE.
WORK ORDER:
INSPECTOR: ROSE RESULT: PASS
REQUESTED: PRIORITY:
SCHEDULED: COMPLETED: 04/28/09
UNPAID FEES: 00 Date Time
MILEAGE: 00 TIME: TRAVEL ONSITE
COMMENTS
FIRST INSPECTION /PLYWOOD GARAGE /FELT PAPER
WORK IN PROGRESS-OK
ALL INSPECTIONS:
INSPECTED INSPECTOR RESULT INSP DESCRIPTION
06/02/09 DOUG PASS BO10 FINAL