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HomeMy WebLinkAbout2800 TAMARACK AVE SUITE 002 v DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# kDa l' on' y: TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# Buil Inspector 644-2511 ext. 230 Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= �jfi7i vc y 7/ $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT /~`00e7L1v APPLICANT ADDRESS APPLICANT PHONE# G 7 7— Z Z Z Z� �0W N SFq OWNER OWNER ADDRESS �'�'y 5/�lrl�— i>✓, ZL_A G7. OOWNER PHONE C ESTIMATED COST$ 151 O Z�,. •�, * IS THIS A CONTRACT COST? Yes _No LG� �o �; �C! FEE ENCLOSED$ SOR•CO TYPE OF JOB: JZNew Installation _ Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: C-TEATING El RESIDENTIAL ri/ U-COMMERCIAL I�+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) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(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 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. 0 -/2;�;�,C , 3a3 ''i ,-� sue/ 5 _/ G 7 CONTRACTORS LICENSE NO. TTPE STATE SIGNATURE OF APPLICANT DATE 3 MODERN MECHANICAL SYSTEMS, INC. Public Act No. 91-95: An act concerning the requirement that licensed contractors as defined in Section 20-330 of the General Statutes, must personally sign each building permit application. Date: 11-21-05 Town of: South Windsor Re: Application for HVAC Gentlemen: In accordance with Public Act 91-95,this letter authorizes the below named agent to sign the above reference permit application. 1. Project Name: ECHN —Medical Building @ Evergreen Walk RADIOLOGY AND BLOOD DRAW LOWER LEVEL Project# 897-008 2. Location: 2800 Tamarack Road 3. Starting Date: 2/21/05 4. Licensed Contractor's Name: Jeffrey A. Clement 5. Licensed Contractor's Trade License No.: SM-1 #2896, S-1 #303543 6. Name of Agent: Edward Hlasyszyn 7. License Numbers of all Contractors involved in the work, if applicable: Sincerely, MODERN ME CAL SYSTEMS, INC. Jeffrey A. Clement President JAC:m 897-002permitHVAC 519 COOKE STREET • P.O. BOX 492 • FARMINGTON, CT 06034-0492 PHONE 660 / 677-2222 • FAX 860 / 676-8305 it An Equaf Opportunity Employer DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT PERMIT# Applica ' ereby: '>., TOWN OF SOUTH WINDSOR BUILDING DEPARTMENT AP OVED 1540 SULLIVAN AVENUE Bldg.Permit# �! 644-2511 ext. 230 3 J S-0 <� Date B i g Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $0-$1,000=$15.00 [Ten';a-nt' o. S eet Lot No. Over$1,000= $15.00 per$1,000 l llEwa CZ� or any fraction thereof Design ion (10kaW— Z4---�) Apt.No. APPLICANT_ c1C� �J7Lai✓( "S �U. APPLICANT ADDRESS l -F).Ktle�aQ C';� L�60Z APPLICANT PHO�N^E# 3,6 C) a4O�—aCXJ d W N S F,q OWNER OWNER ADDRESS 2M a W T C7 0 OWNER PHONE L C ESTIMATED COST$ .�, IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ f� iJ TYPE OF JOB: DSO R-C O� New Installation Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A O RESIDENTIAL BUILDING PERMIT APPLICATION? ❑ YES 0 NO ❑BUSINESS CURRENT USE AND OCCUPANCYL�/( ❑ASSEMBLY ❑MERCANTILE FUTURE USE AND OCCUPANCY 0 EDUCATIONAL ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME � - ,PHONE - -149-0 ❑ STORAGE PQ ❑ GARAGE ADDRESS y� ❑MIXED USE CITY gcx-vwae�w STATE ZIP (Other please specify) TYPE OF`NSTALLATION SIZE OF MAIN DRAIN 4-4 NO. OF TOILETS STYLE NO. URINALS STYLE C) NO.OF BATHTUBS�_ NO.OF SHOWERS NO.OF LAVATORIES S NO.OF CONDUCTORS SIZE !f�— 4 NO.OF STACKS SIZE t/ AREA OF ROOF D;v d#(6WX NO.OF CATCH BASINS — NO. OF FLOOR DRAINS Z NO.OF OTHER FIXTURES _ KIND 9 cSAIVS ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES ❑NO SIZE OF WINDOW _N/A IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS ©N yoc SEWER SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER 24 , WATER HEATER: TYPE (C MANUFACTURERX� O,J jt� DESCRIPTION OF WORK G�j 6-Z-os- THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WORK DESCRIBED AND Irr6-- COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE nPERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NO. T E STATE SIGNATURE OF APPLICANT DATE 6-,F el'17 DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Applic 1�hereby: TOWN OF SOUTH WINDSOR PERMIT# BUILDING DEPARTMENT Zoe/.s APPR 1540 SULLIVAN AVENUE Bldg. Permit# PT 644-2511 ext. 230 Date Buil t'ng Inspector 1 Application must be printed or typed FEE SCHEDULE l �// Location lI of Job: L 0C r, 14 `C�[A!J U V C_F4 1 G\ �� $0-$1,000=$15.00 Street No. ! Street Lot No. Over$1,000= $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT 5 e r"", E APPLICANT ADDRESS P, 0. 13,k 3 W r APPLICANT PHONE# O W N S F,q OWNER L-G l-111,/ OWNER ADDRESS A0 /d A,,kI ,,..,i 0 ) 0 OWNER PHONE N14 C ESTIMATED COST$ ? 00 U. v y .� IS THIS A CONTRACT COST? X Yes _No FEE ENCLOSED$100, TYPE OF JOB: All TYPE R Co New Installation g� _Alteration/Addition/Repair�. Revised 4/01//2002 APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A El RESIDENTIAL BUILDING PERMIT APPLICATION? ElYES ElNO L3 BUSINESS ❑ASSEMBLY CURRENT USE AND OCCUPANCY ❑MERCANTILE El EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE ❑ GARAGE ADDRESS ❑MIXED USE (Other please specify) CITY STATE ZIP TYPE PE OF INSTALLATION/WIRING METHOD G/Ll T Cc.,L�,.`, �,. cl JVIG Cg bl SIZE OF SERVICE SIZE OF MAIN CONDUCTORS NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS NUMBER OF PANELS REMOTE DISCONNECT REQUIRED? ❑YES ❑NO 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 � leL �rl,C 1 . c Qh ✓I�chUi 7 a^�� c �I cv,i nn c��'✓iCeS Axel r U � 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. /0 i CONTRACTORS LICENSE NO. TYPE STATE SIGNATURE OF APPLICAN`] %i/ t DATE r7 Electric # APPLICATION FOR BUILDING PERMIT Plumbing# 7s�O/ 2800 Tamarack Avenue Date: _ 130 D E HVAC # ,14-F4 154C Sprinkler# 32 312 - _ --- - - Estimated Cost $ FINAL P -- -- -- Permit Fee $ Buildin o COMPLETE RED BOXED AREAS Enginee TYPE OR PRINT ONLY Eng.Occupancy Fee $ �� Affidavit for CO o SIGN ON REVERSE SIDE t p z 35. __ _ Total Fee $ / TO THE BUIL ING DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant Location of Work EONE Vet Lot No. — Applicant's Address Tel.# N�,o 674-yado Town r Zip o 6�/ Lic.# D 5 Owner Qen a Architect Owners Addre s_Inp Fi3� Dr\Ie Architect's Address Zip 1)[0m)I �h LT- ZipO,Y.� _ Sq. Ft. New Area: 1st FI. 4 A 8-.5 2nd FI. 3rd FI. Total New Area Purpose of this permit T rJa n4 -A/ -V/> A,- City Water( Well❑ Septic System❑ Sewer Ins: HO SP Cert. Area Basement Garage Approved by Date Use Group Construction Type Revised 6/02 J 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 DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS