HomeMy WebLinkAbout17 Brookhaven Lane (2) PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT / lal
- Application is hereby : TOWN OF SOUTH WINDSOR
APPROVE DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Application must be printed or typed.
Date Bui ing Inspector
1. LOCATION OF JOB
O17r6��r
FEE SCHEDULE No . Street
$ 0 - $19000 - $10 . 00 Floor Apt . No.
Over $19000 - $10 . 00 2 . OWNER Coyvrt CO•,r/.�
per $1 ,000 or
fraction thereof 4 derma (�
3. ADDRESS 1 �� S, ar z1
A.
4 . APPLICANT 04 AJ
5 . ADDRESS ! V C�-��0�-�► /ts' ��
6 . ESTIMATED COST $ .�QO
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $ 19) 41
1✓
9 . TYPE OF BUILDING:
RESIDENTIAL 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 0 /?/001 A�'lO�r ��l-
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION Se.w�ce C�-Ia• ,
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 �.�pr
35 . REMARKS AND FURTHER DETAILS :
�O 303 / 9Q
LICENSE NO . SIGNATURE OF APPLICANT DATE
PHONE NUMBER: cit?
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