HomeMy WebLinkAbout101 Birch Hill Drive (7)PERMIT
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DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROV DISAPPROVED 1540 SULLIVAN AVENUE
r Jk 644-2511 Ext . 230
Da a Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $10000 - 10.00
per $1 ,000 or 2 . OWNER - r h
fraction thereof
3 . ADDRESS /Q /
d S r3
4 . APPLICANT
5 . ADDRESS a 7 Oj r r''h &— r
V e r'n o 01
6, ESTIMATED COST $ p r d D
7 , IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $Q G
9 . TYPE OF BUILDING:
XRESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
Alteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB r
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION J y b
13 . n
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 :
z/Q
LICENSE NO. NATURE OF APPLICANT DATE
PHONE NUMBER: 9 MQ 3 C 6
INSPEr'IOR TIME
LOCATION d I
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
EL TRICAL.
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PLUMBING:
HVAC:
OTHER: