HomeMy WebLinkAbout19 Andries Trail (9) PERMIT /jo
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
7 3 C 41,
644-2511 Ext . 230
Date Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
.r o Thy
FEE SCHEDULE No . Street
$ 0 - $1 ,000 - $10.00 Floor Apt . No.
Over $1 ,000 - $10.00
p e r $1 .0 0 0 o r 2 . O W N E R h2� !yl/+�
fraction thereof
3. ADDRESS
4 . APPLICANT y4llt
5 . ADDRESS k1
6. ESTIMATED COST $ 4
0
7 . IS THIS A CONTRACT COST
Y s N
8 . FEE ENCLOSED $ U J
9. TYPE OF BUILDING :
4--R--ESIDENTIAL COMHERCIAL
10. TYPE OF JOB:
Original Installation
Alterati dit /Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB lv
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NO. STREET T-/ 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 :
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LICENSE NO. SIGNATURE OF APPLICANT DATE
PHONE NUMBER: /� ��/ ?zl�