HomeMy WebLinkAbout20 Brookfield Street (4)PERMIT 0
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is hereby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
3 <T S 644-2511 Ext. 230
a e g Inspector Application must be printed or typed
1. LOCATION OF JOB
2. 33f-0OR =jeLn
FEE SCHEDULE No . Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
per $1 ,000 or
2 . OWNER L, qnjo
fraction thereof
3. ADDRESS
4. APPLICANT. Onx ItjL
S. ADDRESS "1 1 8K,f( lC,,
t Et,/, ., 1 Q:3 L'
6. ESTIMATED COST $
7. IS THIS A CONTRACT COST
Ye No
8. FEE ENCLOSED $ yd- Cf
1q
9. TYPE F BUILDING:7rES IDENTIAL COMMERCIAL
10. TYPE OF JOB:
Original Installation
Alteration/Addition/Repair
RD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11. LOCATION OF JOB 2-C> B!", o k //'
NO. STREET APT. NO ,
12 . TYPE OF INSTALLATION C' to
13 . SIZE OF MAIN FEEDER
14 . NO . OF LIGHT LOOPS Z 15 . NO. OF HEAT LOOPS
16 . NO . OF POWER LOOPS 2 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 Z
26 . NO. OF PANELS 1 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:
Ili' "'T DATE TIMETOR
LOCATION Q
INSPECTION: CODE: RESULT(D/A) :
BUILDING:
l
ELECTRICAL:
0
PLUMBING:
HVAC:
OTHER:
V 4