HomeMy WebLinkAbout15 Benjamin Way (9)PERMIT 0
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
Lz SG 644-2511 Ext . 230
Date ding Inspector Application must be printed or typed
1 . LOCATION OF JOB
77
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 -10.00
p e r $16 000 or 2 . OWNER
fraction thereof
3. ADDRESS
4. APPLICANT
5. ADDRESS 91
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8. FEE ENCLOSED
23)Z
9. TYPE OF BUILDI :
RESIDENTIAL _COMME IAL
10. TYPE OF JOB:
Original Installati n
Alteration/Additi n/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF J O B Zt5
NO. 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 MEAT 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 :
ool
LICENSE NO ,SIGNATU16E OF APPLICANT DATE
PHONE NUMBER: 9—