HomeMy WebLinkAbout32433-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-31977
Date: 11/03/06
THIS CERTIFIES that the building
ALTERATION
Location of Property: 840 MANOR
(HOUSE NO.)
County Tax Map No. 473889 Section 108
HILL LA
(STREET)
Block 3
CUTCHOGUE
(HAMLET)
13 .11
Lot
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated SEPTEMBER 8, 2006 pursuant to which
Building Permit No. 32433-Z
dated
OCTOBER 18, 2006
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is "AS BUILT" ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED
FOR.
The certificate is issued to RALPH & JANE ARMBRUST
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
N/A
ELECTRICAL CERTIFICATE NO.
3010321
10/17/06
PLUMBERS CERTIFICATION DATED
10/30/06 RALPH L. ARMBRUST
~~
Aut orized Signature ....
Rev. 1/81
'J.-9~-L/60h
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
-~~--
)i !()~ .
.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
.
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. 1<'or new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 of I % lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect sit,'11ed by thc applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. /017//&1 r;
New Construction:
><
.
(check one)
L '1-f0A(J~ i/f '-"-
Hamlet
Old or Pre-existing Building:
LocationoIProperty: 8tfo___._j'j<<'J?O'r /f,11 t-"n-<
House No. Street
Owner or Owners of Property: )(0, It h 'l-' ~ 11 cf fff 111 h r 4 '7 f-
Suffolk County Tax Map No 1000, Section /0 ;> Block (JdO -)
Lot <:) I 3 . 0/ {
Subdivision
Filed Map. _,_.. Lot:
Datc of Pen nit. 10/ lii/tJb Applicantj1o.l/4 /... ./?tmhj'.i.i.j-f-__..
Underwriters Approval: -J 0 /0" J. /
,
Permit No. ..2...l L( "5 '7 ;Z
Health Dept. Approval:
PJanning Board Approval:
Request for:
Temporary Certificate
Final Certificate: ~ (check one)
Fee Submitted: $
(fl!ff)~
Ai&iicant Signature
&,;z. '7 I) S '3
C'Ol;31?77
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
32433 Z
Date OCTOBER
18, 2006
permission is hereby granted to:
RALPH ARMBRUST & WF
PO BOX 628
CUTCHOGUE,NY 11935
for
"AS BUILT" ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR
at premises located at
840 MANOR HILL LA
CUTCHOGUE
County Tax Map No. 473889 Section 108
Block 0003
Lot No. 013.011
pursuant to application dated SEPTEMBER 8, 2006 and approved by the
Building Inspector to expire on APRIL 18, 2008.
Fee $
300.00
11
Cu
I~
Authorized
Signature
ORIGINAL
Rev. 5/8/02
@].@]
~ / D Z. - 3 - / ? 1/ ~
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ RALPH ARMBRUST RALPH ARMBRUST ~
~ 840 MANOR HILL LN 840 MANOR HILL LN ~
I CUTCHOGUE, NY 11935 CUTCHOGUE, NY 11935 I
~ Located at 840 MANOR HILL LN CUTCHOGUE, NY 11935 ~
I Application Number: 3010321 Certificate Number: 3010321 I
~ Section: Block: Lot: Building Permit: BDC: ns11 ~
~ 3~~33 ~
~ Described as a occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, desCribed below, located inion the premises at: ~
~ ~~~ ~
~ A visual inspection of the premises electrical system, limited to electrical devices and Wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code andlor standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having Jurisdiction, and found to be in compliance therewith on the 17th Dayof October, 2006. ~
~ Name OTY Rate Ratine: Circuit ~ ~
~ Miscellaneous ~
~ fiinnished second floor and ~
~ added recpticles in basement ~
ii!l as built 1996 ii!l
~ Alarm and Emergency Equipment ~
~ Sensor 1 0 Carbon Monoxide ffil
ffil Sensor 3 0 Smoke ~
~Wiringand~ices ~
~ Outlet 4 0 Fixture ~
~ Fixture 4 0 Incandescent ~
~ Outlet 24 0 General Purpose ffil
~ Receptacle 2 J 0 General Purpose ~
ii!l Switch 4 0 General Purpose ii!l
~ Receptacle 1 0 GFC1 ~
~ An as built inspection, of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to ~
I be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring Sy;::, I
~ ~
~ 1 of 1 ~
I ThiS certificate may not be altered in any way and IS validated only by the presence of a raised seal at the location indicated. I
@].@]
TO\vn Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Pax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:
/()/JO~ b
.
Building Pennit No. j:Z Lf "3 J Z
Owner K <:<./ ph J... .4frrJOrVl ')r
I (Please print)
Plumber: Ii a I f~ J... I/- r rrJ b r VI )r-
I (Please print)
I celiify that the solder used in thc water supply system contains less lhan 2/10 of 1 %
lead.
Swom to before me this :3 / s +
day or ()C.;tb~e'.If- ,20~
~~~
MElINDA L fOi'PING
NoIaIy PubIc, ShIIe of New Yow.
8uIIolk C4MI1ly . No. 4709384
Commission E'xplrts May 31 ;tb C 7
,
Notary Public, .s:vfFo ...fL. County
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)WNER
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'ORMER OWNER
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LAND
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able
odland
odowland
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STREET )(' L.! 0 VILLAGE
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DIST.
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ACR.
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TYPE OF BUILDING
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MICS, Mkt. Value T~'
SUB.
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B. SflEE!-IAIV
VL. I FARM
I
TOTAL . DATE
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COMM. CB,
I REMARKS
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Porch
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Recreation Room
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TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING t)<1 FINAL ~.~\cZ,
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: F~ ~ ~ ok.
F~~~ co~,
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e'". u ~ co/v, (fz)
DATE ( , ~ ;J- ~ - 0 ,
INSPECTOR -~~
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.
3?-LfJ3Z
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [] ROUGH PLBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING t><f FINAL A..-;
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
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y~ 4 ~ Ok
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REMARKS:
DATE
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INSPECTOR ~,~~
FIELil INSPECTION REPORT DATE
COMMENTS
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FOUNDATION (1ST)
FOUNDATION (2ND)
ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
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PERMIT NO.
3J-Y3J"b
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTH OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthoId/
I 0//6 ,20-!lk-
/oJI1.,20~
I
Examined
Approved
Disapproved ale
Mail to:
Phone:
Expiration
~'20A
t~
Building Inspector
APPLICATION FOR BUILDING PERMIT
~t 801>
Date
I
l' ~ ',.(
I
,20~
INSTRUCTIONS
, a. 'Fhis application MUST b~ completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets ofpTans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
e. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new pennit shall be required.
APPLlCA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of South old, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building co~~o?~ ~e.J'nd reg,>lati?~s,. all!!lo admit
authorized inspectors on premises and in building for necessary inspectionsf~-' .~ ~ -
. --b
(Signature of applicant or name, if a corporation)
..'~. r.'
,. L !:-I('/.
,
6A~ (tI/dcci./'<.N.Ir;
(Mailing address of il'pplicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
OW"E',\
Nameofownerofpremises~o..\\?"" ".d-"~) ~c..,""~ A,.,--,...,\--',,,,-ST
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location ofland on which proposed work will be done:
8'10 {VI""nr \-\, \ \ L,v, f'
House Number Street
C,}, <-"'0 :J L e
Hamlet
County Tax Map No. 1000 Section '0$=\ 00
Subdivision
Block ).00
Filed Map No.
Lot O\?l.O\\
Lot
(Name)
I'
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy '", (\<$12- I;;,,<,",~/ 6,^,~\\, ':'J
\ \j ''-' \\
c,J\ (:} 2. \ "F~V'\.
b. Intended use and occupancy
=1
\)t2(Y( . z,/,,.., 'j
L' n e 1-- \ <';-\\1'0 (h,~,,~~
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Addition
Other Work
<..\ "
Alteration
Y"I,. \ It
(Description)
4. Estimated Cost
~ ~OO C':>
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
\
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
"
7. Dimensions of existing structures, if any: Front 'Y / If /
Height ,AI' I U Number of Stories d..
Rear ',if f(')
"
Depth ,::iLj' p,lc "
Dimensions qf sam~ ,structure wi~h alteratio,ns ?.r additions: Front '-/ I In
Depth d.. c.{ R /2 Helght::A \ \ Number of Stones
"
Rear ,-{ I \0
~
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflot: Front
.35'0
Rear
)~o
Depth
~ L-/'1L-\
10. Date of Purchase
Name of Former Owner
I I. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO /
13. Will lot be re-graded? YES_NO ./ Will excess fill be removed from premises? YES_NO ~
,('c,':,,; .:Jr1hhr-''11 '. if" {.,....~<'J.,....
14. Names of Owner of premises . (..1 p4J y' 1J1;"I'~dress ,f'l't He'I1J;/'",/,' i-~I1~ Phone No. ) -I ry.. Lj {. (.' to
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet ofa tidal wetland or a freshwater wetland? *YES_NO L
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE ,REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OFS;;;f~/Ju )
ftflfHAl2I18RUst- + J;N~Ai2 Y'lIM_u >.. being duly swom, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
~~~<<-
( . the
UW AI f'Ai. C,
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perfonn or have perfonned the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith. J A ~
Sworn to before me this A ~ (/ /; /J /
~dayof_1 VC::VG'"\ 20~ "~~ 111. ~
/' j" ~ V~, ---r'-~
Notary Public - ry Signature of Applicant
NBJNDA L TOPPING
tkIIIY I'ubIc. SlIII aI New YOIlI
81M . No. 470rJG4
CIlm1l1lBIlon ~ May 31. :2 Db 7
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Permit #
Permit Date
REScheck Software Version 3.7 Release 1b
Compliance Certificate
Project Title: Armburst
Report Date: 10/17/06
Energy Code:
New York State Energy Conservation
Construction Code
Suffolk County, New York
Detached 1 or 2 Family
Non-Electric
4%
5750
Location:
Construction Type:
Heating Type:
Glazing Area Percentage:
Heating Degree Days:
Construction Site:
840 Manor Lane
Cutchogue, NY 11935
Owner/Agent:
Designer/Contractor:
Compliance Passes Maximum UA 129 Your Home UA 117 --> 9.3% Better Than Code (UA)
Assembly
......
. ~ .'. t . . . . .. . . . ~ t t.
Ceiling 1: Flat Ceiling or Scissor Truss:
Wall 1 : Wood Frame, 16" o.c.:
Window 1: Wood Frame:Double Pane with Low-E:
Window 2: Wood Frame:Double Pane with Low-E:
574
880
30
5
19.0
11.0
0.0
0.0
0.350
0.340
29
75
11
2
Statement of Compliance: The proposed building represented in this document is consistent with the building plans, specifications,
and other calculations submitted with this permit application. The proposed systems have been designed to meet the New York
State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this
page, they are attesting that to the best of his/her knowledge, belief, and professional judgment, such plans or specifications are in
compliance with this Code.
)~... l\tE~~
Builder/Designer Company Name
~
Date
11
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Armburst
Page 1 of4
REScheck Software Version 3.7 Release 1b
Inspection Checklist
Date: 10/17/06
Ceilings:
o Ceiling 1: Flat Ceiling or Scissor Truss, R-19.0 cavity insulation
Comments:
Above-Grade Walls:
o Wall 1: Wood Frame, 16" D.C., R-11.0 cavity insulation
Comments:
Windows:
o Window 1: Wood Frame:Double Pane with Low-E, U-factor: 0.350
For windows without labeled U-factors, describe features:
#Panes _ Frame Type Thermal Break? _ Yes _ No
Comments:
o Window 2: Wood Frame:Double Pane with Low-E, U-factor: 0.340
For windows without labeled U-factors, describe features:
#Panes _ Frame Type Thermal Break? _ Yes _ No
Comments:
Air Leakage:
o Joints, penetrations, and aft other such openings in the building envelope that are sources of air leakage must be sealed.
o Recessed lights must be 1) Type IC rated, or 2) installed inside an appropriate air-tight assembly with a 0.5" clearance from
combustible materials. If non-IC rated, the fixture must be installed with a 3" clearance from insulation.
Vapor Retarder:
o Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors.
Materials Identification:
o Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
o Materials and equipment must be identified so that compliance can be determined.
o Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided.
o Insulation R-values and glazing U-factors must be clearly marked on the building plans or specifications.
Duct Insulation:
o Supply ducts in unconditioned attics or outside the building must be insulated to R-8.
o Return ducts in unconditioned attics or outside the building must be insulated to R-4.
o Supply ducts in unconditioned spaces must be insulated to R-8.
o Return ducts in unconditioned spaces (except basements) must be insulated to R-
o Retum ducts in unconditioned spaces (except basements) must be insulated to R-2.
. Insulation is not required on return ducts in basements.
Duct Construction:
o All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives),
mastic-plus-embedded-fabric, or tapes. Tapes and mastics must be rated UL 181A or UL 1818.
Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500
Pal.
o The HVAC system must provide a means for balancing air and water systems.
Temperature Controls:
Armburst
Page 2 of 4
o Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest
zone.
Electric Systems:
o Separate electric meters are required for each dwelling unit.
Fireplaces:
o Fireplaces must be installed with tight fitting non.combustible fireplace doors.
o Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction provisions of the Building
Code of New York State. the Residential Code of New York State or the New York City Building Code, as applicable.
Service Water Heating:
o Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the water heater has an integral
heat trap or is part of a circulating system.
o Insulate circulating hot water pipes to the levels in Table 1.
Circulating Hot Water Systems:
o Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
o All heated swimming pools must have an onloff heater switch and require a cover unless over 20% of the heating energy is from
non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
o HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table
2.
Armburst
Page 3 014
Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes
Insulation Thickness in Inches by Pipe Sizes
Non-Clrculating Runouts
Circulating Mains and Runouts
Heated Water
Temperature (OF) Up to 1" Upto 1.25" 1.5"102.0" Over 2"
170-180 0.5 1.0 1.5 2.0
140-169 0.5 0.5 1.0 1.5
100-139 0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness for HVAC Pipes
Piping System Types
Heating Systems
Low PressurefT emperature
Low Temperature
Steam Condensate (for feed water)
Cooling Systems
Chilled Water, Refrigerant and
Brine
Fluid Temp.
Range("F)
Insulation Thickness in Inches by Pipe Sizes
2" Runouts 1" and Less 1.25" 10 2.0" 2.5"104"
1.0 1.5 1.5 2.0
0.5 1.0 1.0 1.5
1.0 1.0 1.5 2.0
0.5 0.5 0.75 1.0
1.0 1.0 1.5 1.5
201-250
120-200
Any
40-55
Below 40
NOTES TO FIELD: (Building Department Use Only)
Armburst
Page 4 of 4
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