FAA Form 337 - Taylorcraft



| | | Form Approved |

| | |OMB No. 2120-0020 |

| | |For FAA Use Only |

| | |Office Identification |

| | |      |

|INSTRUCTIONS: Print or type all entries. See FAR 43.9, FAR 43 Appendix B, and AC 43.9-1 (or subsequent revision thereof) for instructions |

|and disposition of this form. This report is required by law (49 U.S.C. 1421). Failure to report can result in a civil penalty not to exceed $1,000 |

|for each such violation (Section 901 Federal Aviation Act 1958) |

|1. Aircraft |Make |Model |

| |Taylorcraft |BC12-D |

| |Serial No. |Nationality and Registration Mark |

| |8908 |N96608 |

| |Name (As shown on registration certificate) |Address (As shown on registration certificate) |

|2. Owner |Steven N. Gervae |751 Seventh St. |

| | |Ontonagon, MI 49953 |

| |      |      |

| |      |      |

|3. For FAA Use Only |

| |

| |

|4. Unit Identification |5. Type |

|Unit |Make |Model |Serial No. |Repair |Alteration |

| | |    |x |

|AIRFRAME |~~~~~~~~~~~~~~~~~~~~(As described in item 1 above)~~~~~~~~~~~~~~~~~~~~ | | |

| |      |      |      |    |    |

|POWERPLANT | | | | | |

| |      |      |      |    |    |

|PROPELLER | | | | | |

|APPLIANCE |Type |      |      |    |    |

| |      | | | | |

| |Manufacturer |      |      |    |    |

| |      | | | | |

|6. Conformity Statement |

|A. Agency’s Name and Address |B. Kind of Agency |C. Certificate No. |

|James McNamara | |U.S. Certificated Mechanic |A & P 1373065 IA |

|3 | | | |

| | | |      |

|513 S. 8th St. | |Foreign Certificated Mechanic | |

|Escanaba, MI 49829 | |Certificated Repair Station | |

|      | |Manufacturer | |

|D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto |

|have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished |

|herein is true and correct to the best of my knowledge. |

|Date |Signature of Authorized Individual |

|      | |

| |      |

|7. Approval for Return to Service |

|Pursuant to the authority given persons specified below, the unit identified in item 4 was inspected in the manner prescribed by the |

|Administrator of the Federal Aviation Administration and is APPROVED REJECTED |

|BY |   |FAA Flt Standards |   |Manufacturer |x |Inspection Authorization |Other (Specify) |

| | |Inspector | | | | |      |

| | | | | | | | |

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| | | | | | | |      |

| |   |FAA Designee |   |Repair Station |   |Person Approved by Transport |      |

| | | | | | |Canada Airworthiness Group | |

|Date of Approval or Rejection |Certificate or |Signature of Authorized Individual |

|      |Designation No. |      |

| |      | |

FAA Form 337 (12-88)

| NOTICE |

|Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be |

|compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. |

|8. Description of Work Accomplished |

|(If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.) |

|1946 Taylorcraft BC12-D N96608 S/N 8908 |

| |

|This aircraft is being modified I/A/W STC SA1-210 Conversion of Taylorcraft Model BC or Model BC12D to the equivalent of aircraft models BC12D85, F19. |

|This STC incorporates fuel system modifications to allow the use of a larger engine. This STC also incorporates minor structural changes to allow a |

|gross weight increase to either 1280 lbs or 1500 lbs depending on model choice, however these structural modifiacations were not accomplished per |

|attached letter of approval from FAA Engineering dated May 21, 1974. Aircraft gross weight remains at 1200 lbs. The TCDS for the F19 allows the use of |

|up to Continental 0-200 engines. I am installing a Continental C-90-12F engine of 90hp. Reference Aircraft Specification A-696 BC12-D-85 and TCDS 1A9 |

|Model F19. This field approval is not valid without the installation of STC SA1-210 with exceptions noted above. |

| |

|Installed Continental C-90-12F engine and Sensenich 76AK-40 propeller.Installed Hanlon-Wilson exhaust due to unavailable Taylorcraft exhaust for this |

|combination, exhaust is certified for installation on C90-12F. Placarded engine instruments in accordance with the engine manufacturers operation manual|

|limits.This engine and prop is a FAA certificated engine and prop combination. This engine mounts directly to the existing engine mount with no |

|modification. No cowling modification is required. No weight and balance changes. No aircraft operational changes. Weight and balance accomplished and|

|recorded in aircraft logbooks. |

| |

|Instructions for Continued Airworthiness |

|#1 This form 337 will become part of the aircrafts maintenance records. These ICA's will be incorporated into the aircraft annual inspection |

|#2 Replacement of Continental C-85 engine with Continental C-90 engine. No interface with other systems. |

|#3 No special control or operation procedures |

|#4 No change |

|#5 Inspect at each annual inspection using Taylorcraft BC12-D Service Manual and Continental C-90 Engine Manual as revised and CFR 43 Appendix D. |

|#6 Reference Continental C-90 Engine Manual as revised. |

|#7 Remove In accordance with Taylorcraft Service Manual. |

|#8 N/A |

|#9 N/A |

|#10 N/A |

|#11 N/A |

|#12 N/A |

|#13 N/A |

|#14 No additional overhaul time limitations |

|#15 N/A |

|#16 For changes to the ICA's contained on this 337 a letter will be submitted to the FSDO for acceptance. Once accepted a log book entry will be entered|

|in the aircraft logbooks identifying the revision, location, and date. END |

| Additional Sheets Are Attached |

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[pic]

U.S Department of

Transportation

Federal Aviation

Administration

MAJOR REPAIR AND ALTERATION

(Airframe, Powerplant, Propeller, or Appliance)

U.S.GPO:1989-0-663-171

U.S.GPO:1989-0-663-171

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