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Home My WebLink About2400 TAMARACK AVE BLOOD DRAW STATION DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT TOWN OF SOUTH WINDSOR PERMIT Application is hereby: OQ BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# ta j�" 644-2511 ext. 230 D Building Inspector 00 Lt Application must be printed or typed / GEC FEE SCHEDULE Location of Job: 4ft -l�-A-..Ajam~ $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 tyL AwuN I Rj tvoo�)a v or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS � M AAFIA D CC APPLICANT PHONE# g(00 U2_-2mSa 1�O W N St-4 t-4 OWNER EyE/z&&eFx/ oley/ Intle, AMC, OWNER ADDRESS Z$p S*pm, Qm QAv C n N , r 06cb i 0 .a �,, �, OWNER PHONE 94 IL ?Y-- C ESTIMATED COST$ _ 3(p_77Qn IS THIS A CONTRACT COST? -AYes _No FEE ENCLOSED$ Z4�'1o0 � �t�• TYPE OF JOB: 35 lZ�ow sO K New Installation 3b 10 0 Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A El RESIDENTIAL BUILDING PERMIT APPLICATION?2KYES ElNO ❑BUSINESS CURRENT USE AND OCCUPANCY *ey ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑ FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑ GARAGE ADDRESS ❑ MIXED USE (Other please specify) CITY STATE ZIP TYPE OF INSTALLATION 0C)074(S►/A(P& SIZE OF MAIN DRAIN NO.OF OILETS STYLE NO.URINALS STYLE NO.OF ATHTUBS NO.OF SHOWERS NO. OF LAVATORIES NO.OF C NDUCTORS SIZE NO.OF STACKS SIZE AREA OF R F NO.OF CATCH BASINS NO.OF FLOOR DRAINS NO.OF OTHER F S KIND ARE TOILET COMPAR S VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO SIZE OF WINDOW IF N ILATOR SIZE OF DUCTS SEWER OR SEPTIC T SIZE OF WATER MAIN SIZE OF WATER PIPING RISER WATER HEATER: TYPE MANUFACTURE DESCRIPTION OF WORK A.-S PCX, THE TMDERSIGNED HEREBY APPLIES FOR A PERMI I I'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. ZOZoI Z 1 6-r, CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICANT DATE TOWN OF SOUTH WINDSOR AFFIDAVIT OF ACTUAL COSTS PERMIT NO: DATE The undersigned, being a duly authorized representative of, 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. I hereby certify that the actual cost of the work performed under this permit is: $ IUD. OD EST Signature of Permit Holder: Name (Please Print) L--Eh/�.I sTL�iJ16 826 Date: p -2 s—ok ......................................................0 a 0 W a 0 0 5 a a E a a E 0 0 a 0 0 E 0 0 8 v a 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 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT TOWN OF SOUTH WINDSOR PERMIT# Application is hereby: 5pj()(Q4 BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date Building Ins for Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 /►L, or any fraction thereof Tenant Designation Apt.No. APPLICANT �— APPLICANT ADDRESS �lC� �i`1P .( E7lG O APPLICANT PHONE# OWN St OWNER ast OWNER ADDRESS ��/jam , Q c oo 0 �o OWNER PHONE z ; C ESTIMATED COST$ �- IS THIS A CONTRACT COST? Yes No — FEE ENCLOSED$ JS�� 1� TYPE OF JOB: DSO R.C O t-1ew Installation —Alteration/Addition/Repair Revised 4/01//2002 PLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF TEM: TYPE OF B ING: TING ❑,RESIDENTIAL C COMMERCIAL VENTILATION ❑ INDUSTRIAL HEATING ❑ STEAM LOW PRE�� LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC if 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) ,lWSCRlEJF,,ALL HEATING EQUIP ENT(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 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 /EW/7 -1 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. / n 3 266 7 L� CONTRACTORS LICENSE NO. ST TE SIGNATURE OF APPLICANT DATE �3 �/ ,w-W Z ' zv 4-3 �l9 a� 1� 0 �.b MECHANICAL FURNACE GAS HEAT) SCHEDULE j3,4003%L TE STATIC PRESSURE ELECTRICAL DATA DX COOLING GAS HEATING TAG OA FAN RPM EXTERNAL MCA MOCP SENSIBLE TOTAL INPUT OUiPIIT BASIS OF DESIGN Weight NOTES FMIN WG AMPS AMPS VOLTAGE MBH MBH MBH MBH MANUFACTURER MODEL OR SERIES RTU-130 0 0.8 24.0 30 480 3 60 95 103 150 121 TRANE YHC102A4RMA 1,200 ROOF CURB ECONOMIZER RTU-201 26.5 35 480 3 60 93 117 200 162 TRANE YHC120A4RMA 1 400 RTU-34 0 1 26.5 35 480 3 60 93 117 200 162 TRANE YHC120A4RMA 1 400 RTU-40 0 1 26.5 35 480 3 60 93 117 200 162 TRANE YHC120A4RMA 1,400 RTU-50 0 1 51.0 60 480 3 60 199 268 250 203 TRANE YFD241C4HG 2 500 RTU-600 0 1.5 57.0 70 480 3 60 236 300 1 250 203 TRANE YFD301 C4HG 2,600 TOWN OF SOUTH WINDSOR AFFIDAVIT OF ACTUAL COSTS PERMIT N0: DATE a-3I0 The undersigned,being a duly authorized representative of,_-Zh= E&v�s'�°�,J LEe(g(r- C _ 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 II, Section 14-31, (a)thru(e),(see attached). 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. I hereby certify that the actual cost of the work performed under this permit is: $ Signature of Permit Holder: Name(Please Print)) Date: V-/Psld I ■■rrarrrrraarraaarrarrraararaaraaaaraarrraaaararraarrrrrrrrarrraararrrarrrarrraa■ 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