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PERMIT
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ERM I T
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby:
TOWN OF SOUTH WINDSOR
APPROVED IZ P VED BUILDING INSPECTION DEPT.
644-2511 Ext . 230
v •.
Date BuildingInspect
Application mustust be printed or typed,,
1 . LOCATION OF JOB
I
S c sc t - gv
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $19000 - 10.00
per $1 , 000 or 2 . OWNER E`C`
fraction thereof
3. ADDRESS al// to S
4 . APPLICANT
5 . ADDRESS e
f 0 608.,
6 . ESTIMATED COST $ M'26 6(E>
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $
9. TYPE OF BUILDING:
PRESIDENTIAL 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 eh c -ZE t C."J c , 4 S
N0. STREET 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 H T CI CUITS ,,
A
9 . N0 . OF POWER OUTLETS
20 . NO. OF ONVENIENCE 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 :
Is lee n_-S
o
C/"57 es
LICENSE NO. SIGNATURE OF APPLICANT DATE
PHONE NUMBER Z<:7 _ a /_> Y_
Lot' N o. 7jtl
1
Building Permit Ic
Temporary Seryice
Permanent Service
Pursuant to Permit No.
1
This Certifies that the Electrical Work for which the above named Permit was granted
has been dulyinspected and is hereby approved.
Owner Electrician
i
Street
19
B it i g Inspector
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