HomeMy WebLinkAbout169 Benedict Drive (6)PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Applica_ on is hereby: TOWN OF SOUTH WINDSOR
APPROVED )ISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Application must be printed or typed.
Date 1lding Inspector
1. LOCATION OF JOB
8 I 1 172
FEE SCHEDULE
No. Street
0 - $19000 - 10.00
Floor Apt . No.
Over $1,000 - 10.00 2 . OWNER i Lorm"t ae- A-m-cL4n
per $1,000 or
fraction thereof
3. ADDRESS 1(co!9 Alen C CT lie
S. c.J nA Sar C T Ob01
4. APPLICANT C-1ltsn . kA
5 . ADDRESS
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8. FEE ENCLOSED $
9. TYPE OF BUILDI G:
RESIDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
i
alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOBpq Z dA •
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 HEAT CIRCUITS 19. NO. OF POWER OUTLETS
r
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 :
UzmL oon-eA WQ lAA R Jim
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: 1Oy!-Y ffV7