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Home My WebLink About2800 TAMARACK AVE SUITE 105 DEPARTMENT DECISION APPLICATION FOR PLUMBING PERMIT Application is hereby: TOWN OF SOUTH WINDSOR PERMIT# /3o/a BUILDING DEPARTMENT ROVE 1540 SULLIVAN AVENUE Bldg. Permit# 2A ae 644-2511 ext. 230 Date INVing Inspector Application must be printed or typed FEE SCHEDULE Location of Job: czt6(c k $0-$1,000=$15.00 Street No. Street Lot No. Over$1,000= �� f $15.00 per$1,000 S;V AnnbuI or any fraction thereof Tenant Designation Apt.No. APPLICANT APPLICANT ADDRESS Ts[now6o aQ (2 T" APPLICANT PHONE# fL L a OWN St OWNER —c l Ic- Q In (Y\O�C`1Jt��SS�- X OWNER ADDRESS Q Amy ( )(O C i OWNER PHONE �� 0 r - C ESTIMATED COST$ �r x IS THIS A CONTRACT COST? _Yes _No FEE ENCLOSED$ l� TYPE OF JOB: �SOR CO� ✓ New Installation Alteration/Addition/Repair 1 g 1 G 3 � Revised 4/01//2002 APPLICATION FOR PLUMBING PERMIT (Continued from reverse side) TYPE OF BUILDING IS THIS APPLICATION ASSOCIATED WITH A 0 RESIDENTIAL BUILDING PERMIT APPLICATION? O YES ElNO ❑BUSINESS CURRENT USE AND OCCUPANCY ❑ASSEMBLY ❑MERCANTILE El EDUCATIONAL FUTURE USE AND OCCUPANCY ❑INSTITUTIONAL ❑FACTORY ENGINEER'S NAME PHONE ❑ STORAGE U GARAGE ADDRESS ❑MIXED USE (Other please specify) CITY STATE ZIP TYPE OF INSTALLATION SIZE OF MAIN DRAIN NO.OF TOILETS STYLE NO.URINALS STYLE NO.OF BATHTUBS NO. OF SHOWERS NO. OF LAVATORIES NO.OF CONDUCTORS SIZE NO.OF STACKS SIZE AREA OF ROOF NO.OF CATCH BASINS NO. OF FLOOR DRAINS NO.OF OTHER FIXTURES KIND ARE TOILET COMPARTMENTS VENTILATED TO OUTER AIR BY A WINDOW ❑YES 0 NO SIZE OF WINDOW IF NONE C.F.M.OF VENTILATOR SIZE OF DUCTS SEWER OR SEPTIC TANK SIZE OF WATER MAIN SIZE OF WATER PIPING&RISER WATER HEATER: TYPE MANUFACTURER DESCRIPTION OF WORK As &A UNDERSIGNEDTRE HEREBY APPLIES FOR A PERMIT TO PERFORM COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONNECTICUT BUILDING CODES IN THE PERFORMANCE OF SUCH WORK. U2012. 1--/ a CONTRACTORS LICENS7NO. �, TYPE STATE SIGNATURE OF APPLICANT DATE DEPARTMENT DECISION APPLICATION FOR HVAC PERMIT A li � TOWN OF SOUTH WINDSOR PERMIT# pp (' BUILDING DEPARTMENT APPROV 1540 SULLIVAN AVENUE Bldg.Permit# - 644-2511 ext. 230 z y� Date ding Inspector Application must be printed or typed FEE SCHEDULE Location of Job: $o-$I,000=$1 s.00 7`'yy T.4,•�A,z,9..,K �� _ Street No. / / Street Lot No. Over$1,000= /�vv>�� /`�/Jf��- /�iyli��: <�� /fir/ 1�,C_ $15.00 per$1,000 or any fraction thereof Tenant Designation Apt.No. APPLICANTU �JL /✓ /`�G' /fr�i -st i 1Y5 s�s>+2 5 �✓� APPLICANT ADDRESS APPLICANT PHONE# Z - O W N S f,q OWNER Gi95 G e5�'<14P6.Clt7/c>�✓ OWNER ADDRESSl> U OWNER PHONE C = ESTIMATED COST$ 3 U y c.- x, IS THIS A CONTRACT COST? '✓I'es No FEE ENCLOSED$ 4� TYPE OF JOB: SO R•C O -,zl�ew Installation _Alteration/Addition/Repair Revised 4/01//2002 APPLICATION FOR HVAC PERMIT (Continued from reverse side) TYPE OF SYSTEM: TYPE OF BUILDING: U-HEATING ❑RESIDENTIAL Q-Ar/C POMMERCIAL q,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 °F INSIDE OF DIFFERENCE OF TOTAL HEAT LOSS(BTUH) OF(HEAT LOSS SHEET MUST ACCOMPANY APPLICATION) DESCRIBE ALL HEATING EQUIPMENT(INCLUDING MAKE&MODEL NO.) Oda, ge9v, Z4,1.7 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. Zg g& / C- CONTRACTORS LICENSE NO. E STATE SIGNATURE OF APPLICANT DATE 3 -/ -v 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 SOUTH WINDSOR AMBULATORY CARE, INC. Project# 897-007 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 6. Name of Agent: Edward Hlasyszyn 7. License Numbers of all Contractors involved in the work, if applicable: Sincerely, MODERN MEC CAL SYSTEMS, INC. Jeffrey A. Clement President JAC:m 897-002permitHVAC 519 COOKE STREET • P.O. BOX 492 • FARMINGTON, CT 06034-0492 PHONE B60 / 677-2222 • FAX 860 / 676-e3O5 An Equaf Opportunity Employer i Ele ri Zoe/� APPLICATION FOR BUILDING PERMIT I�AC'## /n / 2800 Tamarack Avenue Date: �� ti Sprinkler# 32291 / FINAL --_ - Estimated Cost $� L� Building (i COMPLETE RED BOXED AREAS I Permit Fee $ 7 • Engineering Occupancy Fee $�Q__ Affidavit TYPE OR PRINT ONLY Eng. Insp. Fee $ Appr. for C � �J� SIGN ON REVERSE SIDE / Total Fee $� TO THE BU DING DEPARTMENT,TOWN OF SOUTH WINDSOR, CT (Additional Cost) $ The undersigned hereby applies to do work according to the followin o� Applicant e6e4ANI,: n Location of Work6,dA4��✓Lf�i/GCn AlezZA`Lot No. Applicant's Address Qoo �;s`Ie� Ar,Y� Tel.#R&O 6 7;0� 90,d&__ Town Zip dk66 i Lic.# Owner LC Gas Architect C-rcoo Owner's Address ZZO E;S�er Df,)K Architect's Address IPO F;�l re, Drj'y Oyu rl Zip 0 boo I y�� Zip Dh�Oy 1 Sq. Ft. New Area: 1st FI. 2nd FI. 3rd Fl. Total New Area% 7(as -F Purpose of this permit '72-,la a Cm�. ry t lei Sc g2m zii 4,-A� 4 Ar.�,E Cj ,--e Z�c• . iTC,�✓ ��1� Gifu/ �� ii'� � ' ��lc :��. J City Water Well❑ Septic System❑ Sewer Ins: HO SP Cert. Area Basement Garage Approved by Date 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 which this buildi=nd'its se is allowed. Signed U. 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 Inspection / Approval Date By Appl Code Description Due Whom Code Comment ------------------------------------------------------------------------------- **-32291-B 47,000 P03 ROUGH 02/01/06 JFF A WITH PAUL AND PLUMBER DWV SW AMBULATORY MAIN FLOOR AN LOWER LEVEL ALSO SLOP MAIN BATHS E03 ROUGH 02/09/06 PJP A OK TO INSULATE EXCLUDE SHAFT ,CLOSET HALL B10 FINAL 05/04/06 CJD D REAR EXIT DOOR B10 FINAL 07/07/08 CJD A **-13034-H 38,000 **-13010-P 13,000 i^�