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PERMIT #
R A
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT ' �3
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
16 � ��� 644-2511 Ext. 230
Date Building Inspector Application must be printed or typed
1. LOCATION OF JOB jj��
J3 4
FEE SCHEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt. No.
Over $1,000 - $10.00 per $1 ,000 Qr 2 . OWNER
fraction thereof
3. ADDRESS
4, APPLICANT rY1
5. ADDRESS
6. ESTIMATED COST $ D
7 . IS THIS A CONTRACT COST _
Yes No
8 . FEE ENCLOSED $_IOU
9. TYPE OF BUILDING :
'RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
✓Alteration/Addition/Repair
BD 3A 11/88
-T- _ '.-".`_ _ ._: .. .^,��-'_,F.�..�...� �;_..rF•-'�.._ 3'n'CT'"RR'.r"'�"�' w..-.-+ray�gr 7/'"."'^.'..+.,,r't,'oN'� -=-s .c'o'.Ls�";-...ys.;,S'i';-�n,r^....q..,-.,.
L#)t No..
Building Permit
Temporary Service
Aermanent Service
Pursuant to Permit No., 3
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly inspected and is hereby approved.
Owner .� U k- (>r'/ --e, e tl Electrician
rA f
St r et
Building Inspector
t
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB /,30 Ar/
NO. STREET APT. NO,
12 . TYPE OF INSTALLATION /CUO afi,"J4 SfC U C�c. K L.-
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 :
s � �
AN',
LICENSE NO. SIG IfAeleU E OF APPLICANT DATE
PHONE NUMBER:
1 ,
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
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92-12347-E 400
E01 SERVICE 09/17/92 003 A RELEASE ISSUED OK
Total Est Value 400