HomeMy WebLinkAbout169 Benedict Drive (11)PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
P
644-2511 Ext. 230
Application must be printed or typed .
Date Build ng Inspector
1. LOCATION OF JOB
FEE SCHEDULE No. Street
4S-e/n Pin
0 - $19000 - 10. 00 Floor Apt . No.
Over $1,000 -10.00
per $1 ,000 or 2 . OWNER U,e_/4,a t-yy)Cra c
fraction thereof
3. ADDRESS I&q /3e,j P '&T ()/z
S, a) adsooe- C i
4. APPLICANT
i
5 . ADDRESS- q-yn
6. ESTIMATED COST $d
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $
Q
9. TYPE OF BUILDING:
RESIDENTIAL 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 !p [ / p y, p 0 S• (,yi I&d-
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 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 :
d'll
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER: (fyy-L/&DY7