HomeMy WebLinkAboutE-06-868 # 106 Electrical PermitsWPS - Permit
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WPS - Permit
Work Order information
Utility Auth/WO #: 01503165 Date: 02/092006 Company MARY BLUNDELL
Rep:
Report By: YAR 121 CAMP ST UNTIJR VILLAGES AT CAMP ST
Status: PLAN lie�&e: NEW Type: RES
Nature of Work: NEW 100AMP UG TO TRANSF#090 - CONN TO HH - TRANSF IS VISABLE IN NEW
DEV MILL POND -1600 SO FT - NO AC - ELEC RANGE & DRYER - GAS HEAT &
HOT WATER - CROSS STREET IS BUCK ISLAND ROAD
Service Information:
There is no Service Information.
Permit information
Permit #: E06-889 Meters: 1 Reseal (Y/N): Y Date: 04/112006
Inspector: W10060 Description:
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http://Www.nstaronline.comlappslwpslwpspermit.cfm?Page=Pernut&Unique= f ts_'2006-0... 4/11/2006
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00
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TOWN OF YARMOY
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(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
To the Inspector of Wires: By this application the u dersigned gives
work described below. _ f
Location (Street & berms _ JV 1 C:
Owner or Tenant C-) e—
Owner's Address
(OFFICE USE ONLY)
Fee: $ 0� S'417,1
PERMIT NO.
1'
Date: Wltl AAAk Imo- (gyp
of his or her intention to perform the electrical
Is this permit in conju on with a building permit? �Yes 71 No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead
New Service Amps « / �? olts Overhead
Number of Feeders and Ampacity
Location and Nature of Proposed electrical
Undgrd [71 No. of Meters
Undgrd qk—�No. of Meters {
Completion of the. following table may be waived by the Inspector of Wires
No. of Recessed Fixtures
No. of Ceil.-Sus . Paddle Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of Lighting Fixtures
Above In-
SwimmingPool grnd. grad.
No. of Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. of -Detection an
Initiating Devices
No. of Ranges
Total
No. of Air Cond. Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
Number
— — —
Tons
— —
KW
— —
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Municipal
Local Connection Other
No. of D
Dryers
ry
Heating Appliances KW
g PP
SecNity Systems:
No. of Devices or Equipvalent
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. H dromassa e Bathtubs
y S
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or E u ent
ival
Attach additional detail if desired, or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued unless the licensee provides
proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in
force, and has exhibited proof of same to the ermit issuing office.
CHECK ONE: INSURANCE BOND 71 OTHERC] (Specify:)
(Expiration Date)
Estimated Value f El trical Work: (When required by municipal policy.)
N1 Work to Start: a Z Insp ctions to be requeste in ccordance with MEC Rule 10, and upon completion.
I certify, andotheins and e ies erury,lthat 1�1� nfo�atnonthis plication is true and complete
RM NAM- �—' \'' `� LIC. NO.
censee: Sig ature Zv LIC. NO.
�I7f applicab "e in the lice s umber li Bus. Tel. No.:
Address�� 'L Alt. Tel. NO. -
OWNER'S INSURANCE WAIVER: I am aware that th License 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) owner owner's agent. 7
Owner/Agent
Signature Telephone No
[Rev.04/001