HomeMy WebLinkAbout15 Apple Tree Lane (18) PERMIT /
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
i
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVE DISAPPROVED BUILDING INSPECTION DEPT.
/0.3/-Cff j4e. 644-2311 Ext. 230
Date Building Inspector Applications must be printed or typed.
1. LOCATION OF JOB
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FEE SCHEDULE Notly Street
Floor Apt. No. i
S 0 - $1,000 - $10.00
Over $1,000 - 2. OWNER 2 uSs'e(
10.00 /
per 1,000 or �/e e
3. ADDRESS '
fraction thereof —
4. APPLICANT � y`�% —_lellel-c-L)d --
5. ADDRESS_ Z Z S'�T 1
fd
C 7-
ACTUAL COST $ FEE $ 6. ESTIMATED COST S ZO 0a. 00
ESTIMATED COST $ FEE $ 7. IS THIS A CONTRACT COST? Q YES 'M NO
FILE COMP. BY BALANCE $ 8. FEE ENCLOSED $�
9. ELPE OF BUI LDINC:
.SIDENTTAT. C1 COM ERCIAL
10. TYPE OF Jn:j:
ORIGINAL ALTERATION
C3 14STALLATT0% MADDITION
REPAIR
APPLICATION FOR ELECTRICAL PfwPArr(Continued from xeverse Side)
11. LOCATION OF JOB /.SAV1,f
NO. 7 STREET _ FLOOR APT. NO.
12. TYPE Or INSTALLATION Se r J I ce 6d4 9z
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 PMER uvrl.LTS
20. N0. 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 PANELS
29. NO. OF SWITCHES 30. A/C LOAD 31. SIZI OF POMM FEEDERS
32: NO. OF FIXTURES 33. TOTAL HORSEPOWER
34. NAMES OF SUBCONTRACTORS AND THEIR TRADES
35. REMARKS AND FURTHER DETAILS:
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LICENSE)NO. SIGNATURE OF APPLICANT D�
PHONE NUMBER: