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? PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPRO DISAPPROVED 1540 SULLIVAN AVENUE
(J!ft 644-2511 Ext. 230
bate Building Inspector Application must be printed or typed
1. LOCATION OF JOB
A/c-C, Y I 1.F
FEE SCHEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $1 ,000 - $10.00 2 . OWNER CIZOi 114 T76gdu37-
per $1 ,000 or
fraction thereof
3. ADDRESS �0 • j3aK .`Z 31
CT
4. APPLICANT R4--y &t ee ms
5. ADDRESS /O c?7�
6. ESTIMATED COST $ 3015
ro
7 . IS THIS A CONTRACT COST
Yes No
8. FEE ENCLOSED $ d
9. TYPE OF BUILDING:
RESIDENTIAL '-'COMMERCIAL
10. TYPE OF JOB:
original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB /.? $� /..Q dy 2 ///L( /Cv,J
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION
13 . SIZE OF MAIN FEEDER
14. NO. OF LIGHT LOOPS 15 . NO. OF HEAT LOOPS
16. NO. OF POWER LOOPS 17 . NO. OF LIGHT OUTLETS
18 . NO. OF HEAT CIRCUITS 19 . NO. OF POWER OUTLETS
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT CIRCUITS
22 . NO. OF POWER CIRCUITS 23. NO. OF LIGHT CIRCUITS
24. SIZE OF HEAT CIRCUITS 25 . NO. OF MOTORS
26 . NO. OF PANELS 27 . TOTAL WATTAGE
28. NO. OF POWER FEEDERS 29 . NO. OF SWITCHES
30. A/C LOAD 31. SIZE OF POWER FEEDERS
32. NO. OF FIXTURES 33. TOTAL HORSEPOWER
34. NAME OF SUBCONTRACTORS AND THEIR TRADES
35 . REMARKS AND FURTHER DETAILS :
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LICENSE NO. OSIGNATURE OF APPLICANT DATE
PHONE NUMBER: `?' 7 v;,? �3
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Lbt No.
Building Permit !Y k
f T mporary Service
Permanent Service !
Pursuant to Permit No. f
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly inspected and is hereby approved.
Owner - y 4 AV l �°,J e v, � S ElectricianS n a N ).ec
Street
Building Inspector
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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92-12310-E 300
E01 SERVICE 08/20/92 003 A TEMP POLE/LOCATED BEHIND TRAILER/RELEASE ISSU
Total Est Value 300