HomeMy WebLinkAbout18 Dart Hill RoadL L.
PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT 3 b
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVE DISAPPROVED 1540 SULLIVAN AVENUE
644-2511 Ext. 230
D to Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
l
FEE SCHEDULE No . Street
0 - $19000 -10.00 Floor Apt . No.
Over $1,000 - 10.00 2 . OWNER
per $1 ,000 or
fraction thereof 3. ADDRESS
v
4. APPLICANT
S . ADDRESS lJ? e- 4C!'
6, ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
QU
8. FEE ENCLOSED $ /0
9. TYP::
S
F BUILDING:
IDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
lteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB l 4
N0. STREET APT. NO,
12 . TYPE OF INSTALLATION Q-'li
13 . SIZE OF MAIN FEEDER 4Z)j- l
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 :
LICENSE NO. ATURE OF APPLICANT DATE
PHONE NUMBER: ``
Inspection / Approval Date By Appl
Code Description Due Whom Code Comment
92-12367-E 500
E01 SERVICE 10/06/92 003 A SERVICE UPGRADE/CLOSEOUT
Total Est Value 500
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1 t A
Lot No.
Building Permit
Temporary Service
rmanent Servi e
M
Pursuant to Permit Na
This Certifies that the Electrical Work for which the above named Permit was granted
has been dul inspected and is hereby approved.
AlOwner Electrician
Street C,
19
Bui ding Inspector