HomeMy WebLinkAbout209 Brook Street (13)f
PERMIT
DEPARTMENT DECISION APPLICATION FOR ELECTRICAL PERMIT
Application is h reby: TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.
APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
LIT
644-2511 Ext . 230
to B g Inspector Application must be printed or typed
1. LOCATION OF JOB
FEE SCHEDULE No . Street
5
0 - $19000 - 10.00 Floor Apt . No.
Over $1,000 - 10.00
per $1 ,000 or 2 . OWNER
fraction thereof
3. ADDRESS r
f2:2.
4. APPLICANT
5. ADDRESS
G
6. ESTIMATED COST $
7. IS THIS A CONTRACT COST
Y s
8. FEE ENCLOSED $
9. TYPE OF BUILDING:
PRESIDENTIAL 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
NO. STREET APT. NO,
12 . TYPE OF INSTALLATION D.' t' X
13 . SIZE OF MAIN FEEDER f
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. SIGNATURE OF APPLICANT DATE
PHONE NUMBER: