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Home My WebLink AboutBLDE-24-1249 i. ` l.ommonw.alth o`///aasachrw[(a Officialt t�/ 1� cc--/t,, cc77 nn Permit No. -�,�._'Igoe? JJ.pa.G,r.nt o`Jir.Jiroicd iI '° Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN iNK OR TYPE ALL INFORMATION) Date: 7-.29-a y City or Town of: t4iftMtx. fih To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 2 2 i I)).144.4) L,y_ . Owner or Tenant SAC.k / /LeA)A Telephone No.'s'I!, j q-i(7]3 Owner's Address is this permit in conjunction with a building permit? Yes i N No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /60 Amps /,)O I 014,6 Volts Overhead©" Undgrd❑ No.of Meters / New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t vt,P) AA„p t«Oc7// /ea.Pee Mt 8477["an•►t. L i.et..L deoo A m S/r'ioK6 XIL,Jec.-rs- Sv6 yo Q.wC! l.v BR,T,c,.,6.c.7- Completion of the followinktable m be waived by the Inspector of Wires. otal No.of Recessed Luminaires t No.of Ceil.-Se (Paddle)Fans No.of TVA sP• Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 2 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting ggrnd. grnd. Battery Units No.of Receptacle Outlets aG No.of Oil Burners FiRE ALARMS No.of Zones / No.of Switches I No.of Gas Burners No of Detectionand Initiating and g No.of Ranges No.of Air Cond. Total, No.of Alerting DeRceE C E ,I E p No.of Waste Heat Pump Number Tons KW DetNo.of Self-ContainertI :d Disposers Totals: — Detection/Alerting)evycgsy _ Muni"PF. Lft 2024 No.of Dishwashers Space/Area Heating KW Local 0 Cones nsi n No.of Dryers Heating Appliances KW NSecurity of ysteoss' IM(rARTMENT No.of Water KW No.of No.of Data Wiring: -. Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicationsof Dices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such c_ov�ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [T�BOND 0 OTHER 0 (Specify:) 4s4&l .,ry 'it-2S I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: .6-0, ..4Ro w D' -J LIC.NO.: 0 ,ive Licensee: Signature +r/ LIC.NO.: (If applicable,enter"exempt"in the license number line.) / OaI .7 Bus.Tel.No.#/e-s:3J-9/ys Address: .�.'l�/9,oLEC.ec�S 7- D•e Sad .'4 Alt.TeL No.: 'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,i hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ brn OP1 E W/7 e g ilia)I.c.6i41 C. ec, 6 z (e eI d.,M (.4,0 )