HomeMy WebLinkAbout160 Benedict Drive (6) PERMIT
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DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT ---
Application is hereby: BUILDING INSPECTION DEPTMENT
APPROVED DISAPPROVED TOWN OF SOUTH WINDSOR
236-3231
Date Building Inspector
Applications must be printed or typed.
1. LOCATION OF JOB
No. Street
FEE SCHEDULE
Floor Apt. No.
_— ---- -- -A
$ 1 .00 - $ 200 $3.00 *
$2 01 .00 - $ 600 $4 .0 0 . 2. OWNERrt,� ✓� C�! _
$601 -00 - $1000 $6.00
or fraction thereof 3. ADDRESS f" T3 Y�i •c rG f _���!
4. APPLI CAN'T
5.
sr--
1 ACTUAL COST $ FEE $w 6. ESTIMATED COST S
i
ESTIMATED COST $i_ _ FEE $ 7. IS THIS A CONTF.AC,T.COST? Q" YES Q NO
FILE COMP. BY BALANCE $ B. FEE ENCLOSED
9. TYT' ' OF
- Rr:SIUEI�7 T1�, C0%,0HERCIAL
10. TYPE OF Jr)6:
ts:tIG I NAI, ALTEFUXTION
!'JST ti J A 1 Tt�"% ADDI rt0\
]REP AT h
APPLICATION FOR w LEcPK.LCAI, f'FRdrr(Continued i cow ::evarse Sick')
11. LOCATION OF JOB c2 1.3 e-i ceJr c.- ( �r
NO. STREET FLOOR APT. NO.
12. TYPE OF INSTALLATION O� _ � ✓ _C l4_L 1
13. SIZE OF MAIN FEEDER _ -�_
14. NO. OF LIGHT LOOPS l5. NC. OF HEAT LOOPS 16. INO. OF PC--.•F Z
17. NO. OF LIGHT OUTLETS 18. NO. CIF (:T icCI"T5 19. NO. OF
20. NO. OF CONVENIENCE OUTLETS 21. NO. OF HEAT C1 KCUITS 22. NO. OF
23. NO. OF LIGHT CIRCUITS - 24. SIZE OF HEAD' CIRCUITS__ 25. NO. OF
'26. NO. OF PANELS_ 27. TOTAL, WATTAGE _ _ 28. NO. OF PO4ir R PANF;.S_-_
29. NO. OF SWITCHES 30. A/C LOAD.-------- 31. SIZE OF PO'r:ER FEEL)E,�S_-
32. NO. OF FIXTURES 33. TOTAL HORSEPOWER_
34. ►DAMES OF SUBCONTRACTORS AND THEIR TRADES_—_
35. REMARKS AND FURTHER DETAILS:
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ALL WORK COVERED BY THIS APPLICATION HAS BEEN AUTHORIZED BY THE OWNER OF TEI"S PROPt::1TI'
AND WILL BE DONE TN STRICT ACCORDANCE WITH THE BUILDTNG CODE.
LICENSE NO. SIGNGTUI(E OF APPLICANT
PRUNE NUMBER: