HomeMy WebLinkAbout197 Brook Street (6)i
PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
ro / 644-2511 Ext. 230
at Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
Ig(7 5rdd
FEE SCHEDULE No . Street
0 - $10000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
per $1 ,000 or 2 . OWNER hovlf
fraction thereof q7 gY S3. ADDRESS `
C
r
4, APPLICANT Cj I.c4 6_
5. ADDRESS 2,
kafz a k. Cod., Q 60
6, ESTIMATED COST $ 1,5
7 , IS THIS A CONTRACT COST
Yes No
8. FEE ENCLOSED $
9. TYPE OF BUILDING :
PRESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
teration/Addition/Repalr
aD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB 7-7 11 e-v/it,
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 :
1
e
2-
LICENSE NO.SIGNATURE OF APPLICANT DATE
PHONE NUMBER:
yy-.t-' 5'f• Ste.. P __ u I .1 ( Y7, .
J'
S __.__ . -_ __'__ M __ _V-"
TCOR J DATE tZ.. TIME
LOC. -)N 197 61-,00
t
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
ELECTRICAL: c)
l
PLUMBING:
HVAC:
OTHER: