Project Survey Form

The following information is required in order to determine which type of Air Conditioning / Heating system that the property currently has in place.
Property Name:
Address:
City/State/Zip:
Phone:
Fax:
Contact:
Owner or Mangement Company Name:
What brand name
currently exists?
Model#
Btuh Capacity, Cool/Heat /
Square Feet to be conditioned
(Length x Width)
___________________Square Feet
Voltage
(check appropriate voltage)
115 230/208 277 √
Amperage
(check circuit breaker)
15 20 25 30 √
Heat Pump Yes No √
A/C with electric heat strip Yes No √
Age of Unit
What type of wall construction exists?
Frame Masonry Panel Glass
Please provide the following dimensions
*Note: Measure outside edge to outside edge
Please provide the finished wall dimensions
What is the thickness of the wall
Does any of the sleeve sit outside?
Air Conditioning / Heating system
G
W
20 amp
G
W
30 amp
15 amp
20 amp
30 amp
277V Rating Power Cord Plugs
NEMA 7 Configuration
250V Rating Power Cord Plugs with LCDI Device
NEMA 6 Configuration
Power Cord Plugs
Please provide any additional information that may be needed:
Wall Sleeve
A=
B=
C=
B
A
C
1870 Bath Ave.,
Brooklyn, NY 11214