HomeMy WebLinkAbout163 Birch Hill Drive (16) PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
APPROVE 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 $1,000 - $10.00 P n0v It 61P—r,9AJ-t—
per $1 ,000 or2 . OWNER Fv C
fraction thereof
3. ADDRESS
4. APPLICANT
5 . ADDRESS ' N �
C4- &Ooqo -
6. ESTIMATED COST $ ��� OO
7 . IS THIS A CONTRACT COST--
Yes No
8 . FEE ENCLOSED
9 . TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10 . TYPE OF JOB :
Original Installation
lteration/Addition/Repair
BD3A11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB l
N STREET APT. N0
12 . TYPE OF INSTA
LLATION Upq T>je-c- 17 ' L `fLlI LRL o6
c l PW
13 . SIZE OF MAIN FEEDER
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: -f
/ s� C
LICENSE N0 . 7S ATURE OF APPLICANT DATE
PHONE NUMBER:
c ✓
/ .
Lot No.
Building permit
Tempora
rY Service
Pbrmanent Service
This Certifies that the Electrical Work for which the Pursuant to Permit No. J1 z-
has been I duty Inspected and is herebY app ve named permit was
rOved. granted
Street All
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