HomeMy WebLinkAbout18 Dart Hill Road L L. PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 3 b
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVE DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext. 230
D to Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
/l
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
v � �
4. APPLICANT
S . ADDRESS ���lJ?�✓ e�- 4C!'
6, ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
QU
8. FEE ENCLOSED $ /0
9. TYP::S
F BUILDING:
IDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
lteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB ��l 4�
N0. STREET APT. NO,
12 . TYPE OF INSTALLATION Q-'li
13 . SIZE OF MAIN FEEDER 4Z)j�- l
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. ATURE OF APPLICANT DATE
PHONE NUMBER: ``�
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
-------------------------------------------------------------------------------
92-12367-E 500
E01 SERVICE 10/06/92 003 A SERVICE UPGRADE/CLOSEOUT
Total Est Value 500
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1 t A
Lot No.
Building Permit '
Temporary Service
..- rmanent Servi e M
Pursuant to Permit Na
This Certifies that the Electrical Work for which the above named Permit was granted
has been dul inspected and is hereby approved.
�- Al
Owner � Electrician
Street C,
�`- 19
Bui ding Inspector