HomeMy WebLinkAbout104 Benedict Drive (4) PERRMIT f�#
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED D A ROV BUILDING INSPECTION DEPT.
644-2511 Ext. 230
4-j'as-M
Application must be printed or typed.
D to Building Inspec r
1 . LOCATION OF JOB
/6 Y ��,� di e t AtOr go
FEE SCHEDULE No . Street
$ 0 - $19000 - $10. 00 Floor Apt . No.
Over $1 ,000 - $10.00
AE,per $1 ,000 or 2 . OWNER r 4 I
d
fraction thereof
3. ADDRESS /Q�►�
063an ELI Dt- ,
d- C1 9 A I-
4. APPLICANT e:7--q� 1416 ,S A
5 . ADDRESS ;27
6. ESTIMATED COST $ S���r Q a
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $
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)
11. LOCATION OF JOB `o'y l_.7 r-H e d ,"c- + 0)- .
r
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION 0
13. SIZE OF MAIN FEEDERcQ y 0 (y
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 :
/ 0 3 .<- 9 0 •-�.a� q
LICENSE NO. VS NATURE OF APPLICANT DATEJ
PHONE NUMBER: 3742 osa
Lot No.
Building Permit
i
Temporary Seryice
Permanent Service
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j
Pursuant to Permit Nolo j
1
This Certifies that the Electrical Work for which the above named Permit was granted
has been duly inspected and is hereby approved.
j
Owner Electrician�a 2tjSJ)r-
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Buil ing Ins
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