HomeMy WebLinkAbout178 Benedict Drive (5) PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT �0�7 �
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext . 230
D,fitdi nspector Application must be printed or typed
1 . LOCATION OF JOB
No . Street
FEE $CE1EDULE
Floor Apt . No.
$ 0 - $19000 - $10.00
Ov r $1,000 - $10.00 2 . OWNER p /1-1 14 7
per $1 ,000 or
fraction thereof 3. ADDRESS J A M O
4. APPLICANTf&
" e -7 D,4 Ply
S. ADDRESS ?c>
L5-'o G&�! A,yp S a
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Ye• `No
8. FEE ENCLOSED $ /6
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
Origin 1 Installation
Alteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB j -7co-, 8e-,ti,,r-- do c-7-- rho
NO. STREET APT. NO .
12 . TYPE OF INSTALLATION
13 . SIZE OF MAIN FEEDER j edt) ,e
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 :
r7oC,-�
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LICENSE NO. SIG TURE OF APPLICANT DATE
PHONE NUMBER: