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HomeMy WebLinkAbout2800 TAMARACK AVE SUITE 102 DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT PERMIT# Application is he TOWN OF SOUTH WINDSOR j? o BUILDING DEPARTMENT APPROVED 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 Date Building Inspector O / 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$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS 69:: -1 `5'C04=z--"� �!�-�twt�wh��✓� c=-r. a6�3�f APPLICANT PHONE# t392;ro-- 7 7- ZL S O W N SF OWNER OWNER ADDRESS OWNER PHONE G Z C ESTIMATED COST$ IS THIS A CONTRACT COST? ✓Yes _No FEE ENCLOSED$ f�bs .. O�� TYPE OF JOB: �R C New Installation Alteration/Addition/Repair Revised 4/01H2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: 4EATING RESIDENTIAL A/C ❑COMMERCIAL �3 VENTILATION 0 INDUSTRIAL HEATING 0 STEAM LOW PRESSURE LIMIT LBS. HIGH PRESSURE LIMIT LBS. ❑HYDRONIC ,,U 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(INCLUDING MAKE&MODEL NO.) .jZeW -tom- LJ y L Z5 GROSS HEATING CAPACITY(INPUT-BTUH) NET RATING(OUTPUT-BTUH) TYPE OF FUEL 0 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. CONTRACTORS LICENSE NO. / T E STATE SIGNATURE OF APPLICANT K/ DATE L 'Z(-U S 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 MANCHESTER EAR, NOSE& THROAT CENTER Project# 897-003 2. Location: 2800 Tamarack Road 3. Starting Date: 11/21/05 4. Licensed Contractor's Name: Jeffrey A. Clement 5. Licensed Contractor's Trade License No.: SM-1 #2896 6. Name of Agent: Edward Hlasyszyn 7. License Numbers of all Contractors involved in the work, if applicable: Sincerely, MODERN ME SYSTEMS, INC. Jeffrey . Clement President JAC:m 897-003permitHVAC 519 COOKE STREET • P.O. BOX 492 • FARMINGTON, CT OB034-0492 PHONE BSO / B77-2222 • FAX BBO / B76-8305 r; An Equal Opportunity Employer STATE OF CONNECTICUT 49190 DEPARTMENT OF CONSUMER PROTECTION 165 Capitol Avenue ♦ Hartford Connecticut 06106 Attached is your license Such license shall be shown to any properly interested person on request. No such license shall be transferred to or used by any other person than the person to whom the license was issued. Visit our website at www.state.ct.us/do STATE OF C6NNECTICUT DEPARTMENT OF CONSUMER PROTECTION LIMITED SHEET METAL CONTRACTOR SMi JEFFREY A CLEMENT JEFFREY A CLEMENT PO BOX 492 519 COOKE ST FARMINGTON, CT 06034-0492 FARMINGTON,CT 06034-0492 LIC./REG NO, FE XP IVE' EIRES 2896 09./01/20051�-f(` 08/31/2006 av,rr�4r I SIGNE STATE OF CONNECTICUT ♦ DEPARTMENT OF CONSUMER PROTECTION Be it known that i JEFFREY A CLEMENT 519 COOKE ST FARMINGTQNT-CT 06034-0492 j has been certified by the DgartmentQ ,C n§timer Protection as a LIMITED SHET TACO TRACTOR ! 1. - Sivt1 >, - -License Effective: 09/01/2005 - I I } Expiration: 08/31/2006 j y Edwin R Rodriguez,Commissioner v { A 7 A h- •. Electric# APPLICATION FOR BUILDING PERMIT Plumbing# 2800 Tamarack Avenue Date: O9 d v HVAC # Sprinkler# 30145 _ _ __ FINAL APPROV S - — _ — Estimated Cost $ 0 Building 'LS�7 COMPLETE RED BOXED AREAS �i Permit Fee $ Engineering . TYPE OR PRINT ONLY Eng.Ins . Feeancy $ Affidavit ► SIGN ON REVERSE SIDE / g p Appr. for C �� - - - -- --__---- __-_--- -� Total Fee $ 3 C C TO THE BUILDING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant]-he Cade CoriPOC4440 Location of Work :2 6 co Ta marcLs A ve- Lot No. Applicant's Address Z00 F' lke-rDr;vG Tel.# g6O.�74 9000 Town A✓on Zip 6 r o6vv f Lic.# 70025 9 Owner EVe reZn Mtoll'tz I ASS06, 1 LLL/Architect 3WM AtX- c- rA 6rr v Owner's Address ZOO -� v Pr—de— Architect's Address Zoo F'%s�e-r Ph Ve- Ayovi-0 GT Zip C600 von (-.T Zip b.6to t— Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area A �n Purpose of this permit—_ Dr Mes ; -0r StijiC k4e,,fior '.4- C + Der �w AA &m u a A.)'%"-1V- v O g D City WateK Well❑ Septic System❑ Sewe>r ( Ins: HO IS Cert. Area Basement Garage Approved by Date n• c`{o Use Group Construction Type Revised 6/02 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 whi this buiIdin and its use is allowed Signed 1 hereby apply for a Certificate of Occupancy for the work escribed in this application for the permit. Signed DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS J Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- **-30145-B 211 B10 FINAL 04/16/07 CJD A DEPARTMENT DECISION APPLICA I FOR PLUMBING PERMIT PERMIT# App ' re TOWN OF SOUTH WINDSOR f E U I # BUILDING DEPARTMENT APPRO 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 3 f SU �j Date B 1 ing Inspector pplication must be printed or typed C 6" ����'4C cation of Job: FEE SCHEDULE - �i $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= $15.00 per$1,000 S �Si� S�tv or any fraction thereof Tenant De ' tion ._ !� Apt.No. APPLICANT 17fe a jca s SW^/PCB APPLICANT ADDRESS P.Q e_2/+ �( l T. , 6E= APPLICANT PHONE# 0— Z42-2©l . OWN SF-4 F,q OWNER U C r OWNER ADDRESS :2,00 6S = . Ayar,� Cg ©6Cb1 ,....�'f y..., F OWNER PHONEOp— C ESTIMATED COST$ 63 a� V �. IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ Op OR-CO , ' 'O�� TYPE OF JOB: R-C New Installation �� tT Alteration/Addition/Repair Revised 4/01//2002 c APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A l BUILDING PERMIT APPLICATION?VIYES O NO ❑RESIDENTIAL 054USINESS CURRENT USE AND OCCUPANCY /Ua,f O�t�Ui^ ❑ASSEMBLY ❑MERCANTILE❑EDUCATIONAL FUTURE USE AND OCCUPANCY .OFF. ❑INSTITUTIONAL � ❑ �2 2 �O FACTORY ENGINEER'S NAME HONE ❑ STORAGE ❑GARAGE ADDRESS 6 & LIZ24 ❑MIXED USE CITY STATE ZIP 2- (Other please specify) RE OF INSTALLATION Ott f 61 NAl_ SIZE OF MAIN DRAIN NO.OF TOILETS�_STYLE F1544 VAWE NO.URINALS-0— STYLE-- 0— NO.OF BATHTUBS_ --O— NO.OF SHOWERS NO.OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS _ SIZE_ �I AREA OF ROOF NO.OF CATCH BASINS 0— NO.OF FLOOR DRAINS-4 NO.OF OTHER FIXTURES KIND 5S j1N ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES'*0 SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SE R SEPTIC TANK SIZE OF WATER MAIN 2 H SIZE OF WATER PIPING&RISER A � WATER HEATER: TYPE A MANUFACTURER /.}.a �l4Lt DESCRIPTION OF WORK HE UNDERSIGNED HEREBY APPLIESA PERMIT TO PERFORMH RK DESCRIBED T COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. CONTRACTORS LICENSE NW TYPE STATE SIGNATURE OF APPLICANT DATE_ t t DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT Application * hereby: TOWN OF SOUTH WINDSOR PERMIT# _� BUILDING DEPARTMENT PROVE 1540 SULLIVAN AVENUE Bldg.Permit# 644-2511 ext. 230 -3 Date Building Inspector ' 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$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANT Sc��a L APPLICANT ADDRESS APPLICANT PHONE# ,429 --c)xc! a F 333 O W N S j � OWNER I`'�U,►�yes}ems !=�✓ ILA « i l,. «i (e, OWNER ADDRESS a g U U O p r, OWNER PHONE C r ESTIMATED COST$ 9 `�, Sf cl 0,CG b .� IS THIS A CONTRACT COST? Yes _No FEE ENCLOSED$ C 7 5• D O f��s O�� TYPE OF JOB: R.C X New Installation V Alteration/Addition/Repair Revised 4/01//2002 J APPLICATION FOR ELECTRICAL PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A El RESIDENTIAL BUILDING PERMIT APPLICATION? ElYES ❑NO ❑BUSINESS CURRENT USE AND OCCUPANCY 12e�u ❑ASSEMBLY ❑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 OF INSTALLATION/WIRING METHOD A� 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 � -,l J2),Y � �a—) e- snCS 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. J TYPE STATE SIGNATURE OF APPLICANT DATE 16110, 6 S fiYw�—!yl cvT� fCNN Csfe,h 0,40 Electric# APPLICATION FOR BUILDING PERMIT Plumbing# Q 2800 Tamarack Ave (10 4) Date: Oz oz . OS HVAC # LZ` - - Sprinkler# 32069 FINAL I i Estimated Cost $ OOd . Budding+f 1 COMPLETE RED BOXED AREAS Permit Fee $ �f 3 .Engine TYPE OR PRINT ONLY Occupancy Fee $ �D.AffidavitEng.Insp.FeeAppr.for Co SIGN ON REVERSE SIDE � Total Fee $TO THE BDEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: Applicant The C&S(i C A Location of Work Y B CIO "ra M&raek Roo d Lot No. Applicant's Address an ltis4er Dr-VG Tel.# S GO. 5-7 4. 7000 Town A yoAi Zip GT od"I Lic.# 9AeZs9 Owner fvuG Architect .,JWR AgA.- 6,0,e✓io Owner's AddreA 6t4 Architect's Address 200 6-AL A-r-tee Zipawl Awdol _ GT Zips 600 Sq. Ft. New Area: 1st FI. 2nd FI. 3rd FI. Total New Area esle Purpose of this permit E_ City Water. Well❑ Septic System❑ Sewer Ins: HO SP Cert. Area Basement Garage Approved by Date Use Group Construction Type Revised 6102 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 whichthis 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 C DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS rCHN EAr5, Nwf ��Electric # /9j`' l f vc( APPLICATION FOR BUILDING PERMIT Plumbing# 2800 Tamarack Ave (10 2) Date: 09.ox •D� HVAC # z y� 7 — S nnkler# pFINAL P S i 32067 Estimated Cost $ Elo, - Permit Fee $ Building It o6 COMPLETE RED BOXED AREASEnginee TYPE OR PRINT ONLY Occupancy Fee $ AffidavitEng.Insp.Fee $ Appr. for CO4t 4 1 ,. IGN ON REVERSE SIDE / Total Fee $ TO THE BUILD NG DEPARTMENT,TOWN OF SOUTH WINDSOR,CT (Additional Cost) $ The undersigned hereby applies to do work according to the following: { �� Applicant Location of Work 2600 A04W Lot No. Applicant's Address Tel.# g60•G 7AIGN12 Town Zip 06 00 / Lic.#^91 o A S9 Owner rchitect / Owner's Addres ZOO Ael4eo- Dei✓C Architect's Address 200 A,'Y o ee "A✓#A Zip oboe 1 '19✓40^1 Zip 46Do/ Sq. Ft. New Area: 1 st FI. 2nd FI. 3rd FI. Total New Area 4 6 Purpose of this permit e City Water Well❑ Septic System❑ Sewer Ins: HO SP Cert. Area Basement, Garage Approved by Date" Use Group_1� Construction Type Revised 6102 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 L-- I hereby apply for a Certificate of Occupancy for the work described in this application for the permit. Signed C -L _ DO NOT WRITE BELOW THIS LINE INSPECTION COMMENTS Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- **-32067-B 121,000 P03 ROUGH 10/17/05 JFF A WITH CHRIS AND CONTRACTOR D/W/V E03 ROUGH 10/21/05 JFF A WITH JIM OF SEMAC B04 INSULATION 11/07/05 JFF A PERIMETER WALLS R19 WITH PAUL B09 OTHER O1/30/06 PJP A W.JFF AND PAUL CASTLE CORP, B10 FINAL 04/11/06 JFF A WITH CHRIS AND PAUL NEED PLUMB AN ELECT PERMI TS B10 FINAL 04/12/06 JFF SPRINKLER PERMIT OK B09 OTHER 04/13/06 JFF SPOKE WITH LOU STEINBERG PLUMB PERMIT UNDER 12002 OK TEC CONTROL SYSTEMS, INC., 13 Pulver Street, Torrington, CT 06790 (860) 489-1456 Certificate of Completion Name of Protected Property: Address: Rep. of Protected Prop.(name/phone): Authority Having Jurisdiction:- Address/Phone Number: 1. Type(s) of System or Service: NFPA 72, Chapter 3 - Local If alarm is transmitted to location(s) off premise, list where: / NFPA 72, Chapter 3 - Emergency Voice/Alarm Service: Quantity of voice/alarm channels: Single: Multiple: Quantity of speakers installed: Quantity of speaker zones: Quantity of telephones or telephone jacks included in system: NFPA 72, Chapter 6 - Auxiliary Indicate type of connection: Local energy, Shunt, Parallel telephone Location and telephone number of receipt of signals: NFPA 72, Chapter 5 - Remote Station: Alarm: Supervisory: NFPA 72, Chapter 5 - Proprietary If alarms are retransmitted to public fire service communications center or others, indicate location and telephone number: Indicate how alarm is retransmitted: NFPA 72, Chapter 5 - Central Station The Prime Contractor: Central Station Location: Means of transmission of signals from the protected premise: _ McCulloh _ Multiplex One-Way Radio Digital Comm. Two-Way Radio Others Means of transmitting alarms to public fire service: a. b. System Location: Page 1 of 4 TEC CONTROL SYSTEMS, INC., 13 Pulver Street, Torrington, CT 06790 (860) 489-1456 Organization/Phone Installer: Supplier: TEC control systems, inc., (860) 489-1456 Service: Location of Record (As-Built) Drawings: Location of Owners Manuals: Location of Test Reports: _ A contract, dated , for test and inspection injaccordance with NFPA standard(s) No.(s) , dated , is in effect 2. Record of System Installation: (Fill out after installation is complete and wiring checked for opens shorts, ground faults, and improper branching) This system has been installed in accordance with NFPA standards ash listed below, was inspected by TEC control systems, inc. on_ includes the devices listed below and has been in service since*a,-"� NFPA 72, Chapters 1"rZ3 43-16'•7 (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Other(specify)f'` Signe; Dated: 0� Organization: TEC control systems, inc. 3. Record of System Operation: All operational features and functions of this system were tested by TEC control systems inc. on and found to be operating properly in accordance with the requirements of: NFPA 72, Chapters 1 2 3 4 5 6 7 (circle all that apply) NFPA 70, National Electric Code, Article 760 Manufacturer's instructions Other(specify): i Signed: Dated: Organization: TEC control systems, inc. Y Page 2of4 TEC CONTROL SYSTEMS, INC., 13 Pulver Street, Torrington, CT 06790 (860) 489-1456 4. Alarm Initiating Devices and Circuits (indicate quantity) MANUAL a) Manual Stations Noncoded, Activating Transmitters b) Combination Manual stations and Guards Tour Coded AUTOMATIC Coverage: Completer Partial: a) Smoke Detectors Ion Photo b) Duct Detectors Ion Photo c) Heat Detectors Fixed RofR Rate Comp. d) Sprinkler Waterflow e) Other (list): 5. Supervisory Signal Initiating Devices and Circuits (indicate quantity) GUARDS TOUR a)1, 4- Coded Stations b) A-ilkE Noncoded Stations Activating transmitters c) wig Compulsory Guard Tour System Transmitters Intermediate SPRINKLER SYSTEM a)-A jit-- Coded Valve Supervisory b) at a Noncoded Valve Supervisory c) k jJ41 Building Temperature Points d) ky14 Site Water Temperature Points e) ;yle Site Water Supply Level Points Electric Fire Pump a) A,ij Fire Pump Power b) . Fire Pump Running c) .j/4 Fire Pump Reversal Electric Driven Fire Pump a) j6.- Selector in Auto Position b) ke1�,- Engine or Control Panel Trouble c) ,.� Fire Pump Running Engine Drive Generator a) Selector in Auto Position b) iyie Control Panel Trouble c) i.4E6 Transfer Switches d) _ Engine Running Other Supervisory Function(s) (specify): Page 3 of 4 TEC CONTROL SYSTEMS, INC., 13 Pulver Street, Torrington, CT 06790 (860) 489-1456 6. Alarm Notification Appliances and Circuits: Quantity of indicating appliance circuits connected to system: Types and quantities of alarm indicating appliances installed: a) Bells inch b) Speakers c) Horns d) Chimes e) Other: r' 9) Visual Signals Type:A-WV ADA f Y_ N Local Annunciator 7. Signaling Line circuits: Quantity Type 8. System Power Supplies a) Primary (main): Nominal Voltage Current Overcurrent protection: Type iQAIuSN- Current Location: b) Secondary(standby): Storage battery: Amp-Hour Rating d A Calculated capacity 24 hours 60 hours Engine driven generator dedicated to fire alarm system. Location of fuel storage c) Emergency or standby system used as backup to primary power supply instead of using secondary power supply: MA Emergency system described in NFPA 70, Article 700 WIA Legally required standby system described in NFPA Article 701 i_ Optional standby system described in NFPA 70, Article 702, which also meets performance requirements of Article 700 or 701. 9. Systems Software ill a) Operating system software revision levels: b) Application system software revision levels: c) Revision completed by: Date: 10. Comments: 567E OTIZ) jLV\'^V'J !Eyt'� OMAC 1 System deviations from NFPA standards: _b./\ iz.WD G (Axot P C!�LN� Gy�� r B I _ Date:A�0 t i r a i Page 4 of 4