HomeMy WebLinkAbout106 Berle Road (18)PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
7///
644-2511 Ext. 230
f
a f e ng Inspector Application must be printed or typed
1 . LOCATION OF JOB
lob 3.1 4 1
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
p e r $1 ,0 0 0 o r 2 . O WN E R Ga/,rd i1 tiY,/ ,o v,
fraction thereof
3. ADDRESS /162f/e led
4 . APPLICANT /yf,9j jl/l//y'
5 . ADDRESS i1
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $ 52t
9 . TYPE OF BUILDING:
S I D EN T I A L COMMERCIAL
10. TYPE OF JOB :
Original Installation
klteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION KJAI-X'R x
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 2
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 :
i5s-3 ec
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: (O 2
IN' ?CTOR TE TIME
LOCATION r
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL:
j- 1 Li
PLUMBING:
HVAC:
OTHER:
L