HomeMy WebLinkAbout1755 Ellington Road Ef)f�r,
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DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
<:APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
y gd &04zo Application must be printed or typed.
a e Building Inspector
1. LOCATION OkrA2%77-,• 420
4C
FEE SCHEDULE No. Street
$ 0 - $12000 - $10.00 Floor Apt . No.
Over $1,000 - $10.00 Ls � adeo
per $1,000 or 2 . OWNER
fraction thereof
3. ADDRESS iV
4. APPLICANT C
5. ADDRESS
6. ESTIMATED COST $ 2�d0•dD
7 . IS THIS A CONTRACT COST
Yes No
8. FEE ENCLOSED $ /D•OO
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)
1755 ELLINGTON ROAD
11. LOCATION OF JOB
NO. STREET APT. NO
12 . TYPE OF INSTALLATION vy;f y4
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. SIG ATURE OF APPLICANT DATE
�PHONE NUMBER: tpC `l o�p�
w . s
not No.,,
Building Permit TrTt, IC
Permanent ovary ervic
Permanent Service
Pursuant to Permit No. Z b
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly inspected and is hereby approved.
Owner�t S �� L t C� Electrician 1<4 te-WtZtz=6,eA.4 ."of,4
Street 7 C C\ram��a�% D
19-Lo
Building Inspector