HomeMy WebLinkAbout200 Benedict Drive (4)PERMIT #
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT /
Application is hereby: TOWN OF SOUTH WINDSOR
APPROVED DISAPPROVED BUILDING INSPECTION DEPT.
644-2511 Ext. 230
Application must be printed or typed.
Date Bu ' ding Inspector
1. LOCATION OF JOB
FEE SCHEDULE No. Street
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 -10.00
2 . OWNER,M e,&per $1,000 or
fraction thereof
3. ADDRESS- ).CO 4 Q V
4. APPLICANT
5 . ADDRESS ? y
6. ESTIMATED COST $
7 . IS THIS A CONTRACT COST
Yes No
8 . FEE ENCLOSED $ Q'
9. TYPE OF BUILDING:
RESIDENTIAL COMMERCIAL
10 . TYPE OF JOB : eo 14 C nn
Original Installati
Alteration/Addition/Repair
BD 3A 11/88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB_ o?Ge
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 :
LICENSE NO.S NATURE OF APPLICANT DA E
PHONE NUMBER: CJ/' L 7->
FLot^No. / A
Building Permit '' /
emporary Service,
Permanent Service
Pursuant to Permit No.
This Certifies that the Electrical Work for which the above namedhasbeendulyinspectedandisherebyapproved
has was granted
Owner 1 A 14
Electrician
Street j
19!L
wilding nspector Or