HomeMy WebLinkAbout115 Benedict Drive (6) PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 119L)�f
Application is hereby :
TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
Application must be printed or typed.
Date Bu ' ding Inspector
1. LOCATION OF JOB
FEE SCHEDULE No . Street
$ 0 - $19000 - $10. 00 Floor Apt . No .
Over $19000 - $10.00
per $1 9000 or 2 . OWNER oli yi ell
fraction thereof 3 . ADDRESS
Sd [�✓► vc� w
4 . APPLICANT e-l-jv�A(o
5 . ADDRESS �� •�l/� �S—�
6 . ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $
9 . TYPE OF BUILDING :
_RESIDENTIAL COMMERCIAL
10 . TYPE OF JOB :
Original Installation
X teratio /Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB // e4-Z-4al" b,-
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION 5F(-,)
13 . SIZE OF MAIN FEEDERS
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 DATE
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PHONE NUMBER: