HomeMy WebLinkAbout275 DIANE DR 1 W
DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT
PERMIT#
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT ��
APPRO"-Inspector
1540 SULLIVAN AVENUE
644-2511 ext. 230 Bldg.Permit#
U
Elate B
Application must be printed or typed
FEE SCHEDULE
Location of Job:
FTTenant
$0-$1,000=$15.00 Street Lot No.
Over$1,000$15.00 per$1,000
or any fraction thereof gnation Apt.No.
APPLICANT
APPLICANT ADDRESS Q, A!�'V �LV V Ip
��-
APPLICANT PHONE# LS(go— ��-
�W N SF OWNER
-4 OWNER ADDRESS -,25-- &.4A e,
.S �110
OrR i OWNER PHONE
C ESTIMATED COST$ O
r►�J�► * IS THIS A CONTRACT COST? Yes _No
FEE ENCLOSED$
1� TYPE OF JOB:
�SOR-Cod New Installation
--Iel<,,teration/Addition/Repair
Revised 4/01//2002
f
APPLICATION FOR HVAC PERMIT (Continued from reverse side)
TYPE OF SYSTEM: TYPE OF BUILDING:
41 HEATING 6 RESIDENTIAL
❑A/C ❑COMMERCIAL
❑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) °f(HEAT LOSS SHEET MUST ACCOMPANY
APPLICATION)
DESCRIIIE AWHEATING,I QUI l NT CLUDING MAKE&MODEL NO)
d /A, dKti 6SAS Ia
13 ofl`e L/y- Ze / 1aLS1V.O
GROSS HEATING CAPACITY(INPUT—BTUH) IdO NET RATING(OUTPUT—BTUH)/Zr
TYPE OF FUEL D(_;tou r lo5
❑OIL—GPM OIL TANK LOCATION :❑INSIDE❑OUTSIDE CAPACITY QT-6
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) If.,,� (,V� &J
(PLANS MUST ACCOMPANY "APPLICAT ON), /
FURTHER DESCRIPTION OF WORK �PlGld?� /' C� w '� d �Ui ,"
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. Q�0/
3 99 L/ F l l C2 rWeclG,;
CONTRACTORS LICENSE NO. TYPE 7dLy/
TE
SIGNATURE OF APPLICANT DATE / ,
.• y
T
i , fry
s• -
r
1
��� . •��'� .� tt' rJ 1����Lr T' l
"h ( / P • Rs Q
I+
21
fir, i
. PROPFR Y OF .
10 PI=1:J1s 1)11%1Vil, SOUTH WINDSOR, COON.
Being Lot -No. 50 on reap entitled "'.dap of HIGH FA-01, 1S Kelly. Road
Sonth Windsor.. Conn . Property of �41ward, Joseph :r Stiill ian Kelly
Sub4iYiders Robert S�tonc of Jack Goldberg Scale 1 " = 501
April 6. 1959 Havdch L. Gri.swuld Sheet .:' of 2"
50 ,
HAY.fIEN L. 0. (131.01.2' C .. i.
( gSA: \3M�av A � n. e ' • `�,
44
Lr
i
1
t
G i` •=��
1
r7/ 1
•,r �''/ /�: o,Sou �� � v � �%� �
t
• YRLIPFRTti• OF
NO PIANE DRIVE SOUTH WINDSOR, COON.
Being Lot No. SO on Map entitled "'dap of HIGH F:tiRNS Kelly Road
South Vindsor, Conn . Property of ►ward, Joseph if lyillian Kelly
Subdividers Roheri atone u, Jack Goldberg Seale I " = 501
April. 6, 1959 Hay:,ch L. Gri.sr:u IJ C .- . Shert of 2"
50 ,
14
t �
t131.k)LI, C .
`l. i.0 J� VIILI a1/
i
2-
,6
E
a
s� J?
-- y5
L 2 Z.,f'
� 1 Z�•O
PROPERTY OF
No. DIANE DRIVE SOUTH WINDSOR, CONN .
Being Lot Ko. 50 on Map entitled "`lap of HIGH FARMS Kelly Road
Swith Windsor, Conn . Property of }:dward, Joseph William Kelly
Subdividers Rohert Stone b' Jack Goldberg Scale 1 " = 50l
April 61 1959 Hayden L. Griswold C .1; . Sheet 2 of 2"
Scale 1 " - Soo
HAYDF,N L. GRIShuLD C . ,:.
FS C--
Electric #. APPLICATION FOR BUILDING PERMIT
Plumbing# 275 Diane Drive Date: �-4-/o
HVAC #
Sprinkler#
FINAL P V --- -- 30592_ __—__ _--- -
FO-0- SIGN
- - Esrimated Cost S /S�BuildinPermit Fee $En nee ' PLETE RED BOXED AREAS Occupancy Fee $
Af6daviTYPE OR PRINT ONLYEng. Insp. Fee $
Appr. for O. ON REVERSE SIDE / Total Fee $
Seem
TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $
The undersigned hereby applies to do work according to the following:
Applicant D a✓ n Jc,a-R" `%ocation of Work 2'2 s 17 o n rz. Lot No.
Applicant's Address `Trel.#(>?��)6 y r -i o r S
Town 6 d v-04 + �p C _ �'_?� Zip D 6 n 4 Lic.#
Owner 6 a M E Architect
Owner's Address ESQ Architect's Address
Zip Zip
Ft. New Area: 1 st Fl. 2nd Fl. 3rd Fl. Total New Area
urpose of this permit 'r;0 7EM o t-t S41 S N e-7 n
City Water❑ Well❑ Septic System❑ Sewer❑
Ins: HO Area Basement Garage
Approve y Date U
se Group---- Construction Type
Revised 6102
I hereby spree to conform to all the requiromerits of the Laws of to Slats of Connecticut and the Ordinar m of the Town of
South Wkideor and to notify the Buk*V Inspector of any alteration in the plans or specifications of the Bulldinp for which this
permit Is asked,and agree that this bu&*V is to be located the proper distance from all street Ines,side yard lines,and required
distaricm from all other zones and is located in which this builft and Its use is allowed.
Signed ALzW�
I hereby apply for a Certiflcate of occupancy for the work described In this application for the permit.
Signed
DO NOT WRITE BELOW THIS LINE
INSPECTION COMMENTS
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
**-30592-B 150
B10 FINAL 06/21/04 JFF A
B10 FINAL 06/21/04 JFF A CLOSEOUT
� s