HomeMy WebLinkAbout111 Bourbon Street (6) PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT l�
Application is hereby:
TOWN OF SOUTH WINDSOR
PPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
1-1,4--q d Application must be printed or typed.
Date B i ding -Inspector
1 . LOCATION OF JOB
)// Am(hn't - ,-It
FEE SCHEDULE N6 . Street
$ 0 - $19000 - $10. 00 Floor Apt . No .
Over $19000 - $10.00
per $1 ,000 or 2 . OWNER
fraction thereof &
3. ADDRESS
,7y � ,1G`
4 . APPLICANT /-
4�j� /�Cj�/'fGJ�j
5 . ADDRESS fl 0
f;/l/7f�LL &
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6 . ESTIMATED COST $ r a
7 . IS THIS A CONTRACT COST
Yes No
loin
8 . FEE ENCLOSED $
9 . TYPE OF BUILDING:
VRESIDENTIAL 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
NO. SrfREtT APT. NO,
12 . TYPE OF INSTALLATION
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 :
q1(w
LICENSE NO . SIGNATURE OF APPLICANT DATE
PHONE NUMBER;-02-9,12(/