HomeMy WebLinkAbout0 Hollis Road PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby :
TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
1A Application must be printed or typed .
Date BuijYding Inspector
1 . LOCATION OF JOB
/ :E4, T
-4k t,
FEE SCHEDULE No . Stree
$ 0 - $19000 - $10.00 Floor Apt . No .
Over $1 ,000 - $10.00
per $1,000 or 2 . OWNER603. I� (314�it'LL
fraction thereof
3. ADDRE5,S U�4 Qf
-LRd
4. APPLICANT �j"
5 . ADDRESS �j,Q
K'4
. Fall, OA (e % "
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST v
Yes No
G
8 . FEE ENCLOSED $ U
9 . TYPE OF BUILDING: � �
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
l.<lteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB It S r ✓�C � ��j q D
NO. STREET APT. NO
12 . TYPE OF INSTALLATION rl
13 . SIZE OF MAIN FEEDER
14 . NO. OF LIGHT LOOPS _ _ 15 . NO. OF HEAT LOOPS
t
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. SIGNATURE APPLICANT DATE
PHONE NUMBER: -S 7
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Luc,)r 1 o,•�',
LL
Lot No. U
Building Permit L)Z- ��L 1,
T mpora�y-Service
Permanent Service
Pursuant to Permit No: / I .T
This Certifies that the Electrical Work for which the above named Kermit was granted
has been duly Inspected and is hereby approved.
Owner �' ' �� .�L t�: Electrician
Street_/-_
1917. _ Building inspector