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PERMIT
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ERM I T
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED I Z P VED BUILDING INSPECTION DEPT.
_ 644-2511 Ext . 230
v � •.
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Date BuildingInspect
Application must ust be printed or typed,,
1 . LOCATION OF JOB
I _
S c 'sc� t -�� gv
FEE SCHEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $19000 - $10.00
per $1 , 000 or 2 . OWNER E`�C�`�
fraction thereof
3. ADDRESS al// to S
4 . APPLICANT
5 . ADDRESS e
f 0 608.,
6 . ESTIMATED COST $ M'26 6(E>
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $
9. TYPE OF BUILDING:
PRESIDENTIAL 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 � eh c -ZE�t C."J c , 4 S
N0. 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 H T CI CUITS ,,A
9 . N0 . OF POWER OUTLETS
20 . NO. OF ONVENIENCE 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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C/"57 es
LICENSE NO. SIGNATURE OF APPLICANT DATE
PHONE NUMBER Z<:�7 _ a � /_> Y_
Lot' N o. 7jtl
1
Building Permit �� �Ic
Temporary Seryice
Permanent Service
Pursuant to Permit No.
1
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly inspected and is hereby approved.
Owner ^` Electrician
i
Street
"..' 19 �
B it i g Inspector
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