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PERMIT
DEPARTMENT DECISION APP-l"ICATION FOR ELECTRICAL PERMIT INS10
Application is hereby:
TOWN OF SOUTH WINDSOR
PROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Application must be printed or typed .
D to Building Inspector
1. LOCATION OF JOB
6 Q 7/,
FEE SCHEDULE No . Street
$ 0 - $19000 - $10.00 Floor Apt . No.
Over $1,000 - $10.00 2 . OWNER .
per $1 ,000 or ,
fraction thereof 3. ADDRESS y
4. APPLICANT .a( &,, uh.,`�04w
L/1.%T SC#
5 . ADDRESS 7d
6. ESTIMATED COST $ Zpa
I
i 7 . IS THIS A CONTRACT COST
Yes No
av
8 . FEE ENCLOSED $ Ad
9. TYPE OF BUILDING:
f � e
RESIDENTIAL `.-'COMMERCIAL
10. TYPE OF JOB :
i Original Installation
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB Q�� �� E J? #I&MWgy
NO. STREET APT. NO
12 . TYPE OF INSTALLATION �y<C-- lDD f ���✓�� `�
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 :
LICENSE NO. SIGNATURE OF APPLICANT D E
PHONE NUMBER:
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F a M
Lot No
i
Building Permit
Temporary Service
C( h
manent Service
Pursuant to Permit No.
s Certifies that the Electrical Work for which the above named Permit was ranted
9 been duly inspected and is hereby approved. ,
C. Ce
ner Electri an
t Zo �, - Q
1
Buil in Inspector.
i -
DATE
INSPECTOR
c
LOCATION ve/-A OS
a
TIME DAY
TYPE OF INSPECTION :
❑ FOOTING ❑ PLUMBING
❑ FOUNDATION ❑ HEATING/AC
❑ FRAMING XELECTRICAL
❑ INSULATION ❑ FINAL
❑ OTHER
4.
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