TOWN OF BLOOMING GROVE

PERMIT APPLICATION

Phone 496-7011         Fax 496-1945

ELECTRIC INSTALLATION-UPGRADES

DATE:          PERMIT # PERMIT FEE:          $75.00                           

SECTION BLOCK  LOT

OWNER NAME: PHONE #

MAIL ADDRESS:

PROPERTY LOCATION:

ELECTRICIAN PHONE#

A copy of Orange County Electric License must be submitted.

CHECK APPLICABLE DESCRIPTIONS:

          SERVICE UPGRADE                     INSURANCE PURPOSE

          ADDITIONAL WIRING                 RESALE UPGRADE

(outlets, lights, switches)

EQUIPMENT                                  ADDITIONAL LOADS

(hydro tub, A/C or similar)                                            LIST:

          REPAIRS

ALL ELECTRIC WORK MUST BE INSPECTED BY A TOWN AUTHORIZED INSPECTOR

APPROVED ELECTRICAL INSPECTORS

JERRY CALIENDO    294-7695                                  

ERNIE BELLO                        569-1759

FRED COCKS             783-9309                                                                      

JOE SWANSON          534-6942                                  

RON HENRY              562-8429                      

RON HELM                 986-6514 APPLICANT’S SIGNATURE

PLEASE BE ADVISED:  It is the owner/applicant’s responsibility to submit proper paperwork, schedule inspections and re-inspections (if necessary) and to properly close out the permit.  A building permit expires one year from the issue date.  There will be a $75.00 fee to close out and

 issue a CO or CC for an expired permit.