HomeMy WebLinkAboutBuilding 14 Arthur Drive (7)DEPARTMENT DECISION APPLICADON FOR EL-ECT'RiCAL PERMIT
PE
Application is hereby: TOWN of SOUTH WINDSOR
BUILDING DEPARTMENT Bld1 Permita#-
7->5
APPROVEk 1540 SULLIVAN AVENUE
L Yio
644-2511 ext. 230
Date lding Inspector Application must be printed or typed
Location ofjob
U,
Street No. Street Lot No.
FEE SCHEDULE
Floor Apt.No.
0 $1,000 - $12.00
Over $1,000
7 00 per$1,000 1-40001,e
or any fraction thereof
ADDRESS A/— fl-ki-Z
OWNERS PHONE#
APPLICANT.
00 11111,11 SF ADDRESS
0
fjj ESTIMATED COST
IS THIS A CONTRACT COST?
YES NO
FEE ENCLOSED $
0 C0 TYPE OF JOB:
Original Installation
Alteration/Addition Repair
Revised 11/95
APPLICATION FOR ELECTRICAL PERMIT(Continued from reverse side)
TYPE OF BUILDING
IS THIS APPLICATION ASSOCIATED WITH A
RESIDENTIAL BUILDING PERMIT APPLICATION YES / NO
BUSINESS
ASSEMBLY CURRENT USE AND OCCUPANCY
MERCANTILE
EDUCATIONAL FUTURE USE AND OCCUPANCY
INSTITUTIONAL
FACTORY
STORAGE ENGINEER'S NAME PHONE
GARAGE
MIXED USE ADDRESS
CITY STATE ZIP
Other please specify)
TYPE OF INSTALLATION/WIRING METHOD
SIZE OF MAIN FEEDERS AND RATING OF WIRE USED
NUMBER OF METERS NUMBER OF DISCONNECTS AND RATINGS
NUMBER OF PANELS REMOTE DISCONNECT REQUIRED 7 YES/NO
NUMBER OF LIGHT CIRCUITS ! NUMBER OF POWER CIRCUITS
NUMBER OF SWITCHES NUMBER OF OUTLETS
NUMBER OF LIGHT FIXTURES A7
NUMBER OF HEAT CIRCUITS_ NUMBER OF A/C CIRCUITS
SEPERATE HEAT LOSS AND A/C CALCULATIONS MUST BE SUBMITTED.
DESCRIPTION OF WORK
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO PERFORM THE WO SCRIBED AND IS
TO COMPLY WITH ALL LOCAL ORDINANCES AND STATE OF CONN. DI CODES IN THE
PERFORMANCE OF SUCH WORK.
NAME STATE LICENSE NO. TYPE SIGNXtURE OF APPLICANT
PHONE NO.s DATE y