HomeMy WebLinkAbout275 Benedict Drive (2)PERMITSDEPARTMENTDECISIONAPPLICATIONFORELECTRICALPERMIT1
Application is hereby : TOWN OF SOUTH WINDSOR
BUILDING INSPECTION DEPT.APPROVED DISAPPROVED 1540 SULLIVAN AVENUE
lAef JA 644-2511 Ext. 230
Ddto Building Inspector Application must be printed or typed
1 . LOCATION OF JOB
75 Temv,e d a0l fir .
FEE SCHEDULE No0.0
0 - $19000 - 0 Z'' Floor Apt . No.
Over $10000 -
per $1 ,000 or 2 . OWNER
fraction thereof
3. ADDRESS 7S o4 dJ•
S- d C604. 6460 75
4. APPLICANT c r/ice c Q
t
5 . ADDRESS
6. ESTIMATED COST $ 57 614) d
7 . IS THIS A CONTRACT COST
AA
8 . FEE ENCLOSED $ J Z
0
9. TYPE OF BUILDING:
ESIDENTIAL COMMERCIAL
10. TYPE OF JOB :
Original Installation
alteration/Addition/Repair
R1) 3A >>i88
APPLICATION FOR ELECTRICAL PERMIT (Continued from Reverse Side)
11 . LOCATION OF JOB
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 .SIGNATURE OF APPLICANT DATE
PHONE NUMBER:'
INSPECTOR DATE J)b TIME
LOCATION
10000,
J I
INSPECTION: RESULTD/A :CODEs-'
BUILDING:
ELECTRICAL:
PLUMBING:
HVAC:
OTHER:
E
F
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