HomeMy WebLinkAboutWire Permit - Permits #12113 - 84 CASTLEMERE PLACE 1/22/2014 IS
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BOARD OF FIRE PREVENTIONREGULATIONS t [Rev. 11071 bj
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
.illwork to be performed in accordance with the Masswbusem Electrical Code C),327 CN4R 1.2.0
{'PL ",r a°E PRTNTIN JIVK OR TYPEALLJYFORW T1 Date.—I -_ I
Wires.-
By this application Elie~undersigned gives notice of his or,her intention to perform the electrical work cam s4:-fi'bed below, �
Location(Street l to ber n&MV-_ �o rer orTeraa _.. Telephone �" . __.
85.a.°..,.1 ` (6
Owner's Address
Is tints:permit in coxats._" ion M-with as building permit? � Y � ..._._ tag (Check Ap._..._..,.TMM_....�m.__.__._._.M...._.�_,....w.._....
roprtat:eBox)
Purpose of uffdirn Utility Authoew2flon
Existing Service_ __.. Amps ._____,.,I___-Volts Overhead Undgr ' o of Meters
N
Lew S° _"ce .6,mps — _ Volts Overbead Ej undgrd ["j Cho.ofMetteaas _
NnAmber of Feeders and Amp2city
Location and Nature of Proposed Electrical Iork � ������a�� .��..._.� .�..�_ .._ _•.
•_ gZrar lettora o the fb1l an table m aw bebe waived 11re IA 0.of
No.of R edLuminaires _ o.of e iL-Susp. a 'at Transformers
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It
Pao.of feet sire Outlets o.of Hot Tubs Generators 1:)_0 *ids
S "rrnrrsan 'enrol Above � a�.rr rraer envy t rttn
No.of Luminaires rl. trtd. tte "tom ,� � a
l lo»of Receptacle Outlets No.of Oil Burners FIRE ALARMS o.of Zonis _ ._..
_ tltrra are
No.of itches No.of a r er
Eder.of n w —Total
_ No.of�.irotrd. � No.of AlertingDevices
Hea710.of _eats Disposers_ t Pimp , t er ey _.__._ o.as el otaa" ecl
"otalss -- fl .tile leva
_.___ ...
Other
MunicipalNo.of'l Dishwashers-s Space/Area Heating C l ' Connection
7° 0.of Dryers tin Appliances Security Systems.-*
No. k vt� r rat v�letit
1"do,of Water No.of o.of Data Wiring:
:
KW Heaters iallaw No.of �v�� or nraattnlertt
"f"elecoiaaseatiearns t �tt
No.Hydromassage Bathtubs No.of Motor "`otal H � �.of" eA or guiva i:._ .,. w..
"l°HER; �.
Attach "t!'onan detail if d sirec4 or as required by the Inspeelor of Ifire< a
Estimated Value of ElectricalWork: (When required y municipal nlcipal policy,.) cf.
Fork to Start:- inspections to be requested in accordance with n Ru
le axle 10,and upon cc.°arrrplehon.
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INSU CE COVERZE. Unless vvaarred by the owner,no permit for-the performance of electrical Work may issue r;n)ess
the licensee provides p of'ofliability insurance including-completed operation"coverage or its substarat%al equivalent:., The
undersigned certifies that such coverage,is in force,and has exhibited proof of'sannae to the permit issuinguffice-
CHECK ONE. INSURANCE El BOND F_j OTBER [..3 (Specify:)
I relfify,under thepains and penaltf oj"perja ,dent t xe_!firmafta ra flats is true and complete-
FIRM NAME: LIC.NO.. A,,?
l ie"ernsee. 1L1 :.NO-
fdf applicable,en Bus.Tel.No.,
Addressa r;• °r _w '' x % t ' Alt-Tel.
*Per M.G.L.c. S. ulres pep ofptabllc S ter"S" .lrgnsew Lic.No
OWNER'Sf . . 1 ' t. k am anvare that tine censee doer noz have the liability irsuratnceµ cove ntge snor aall,Y
required by law. By rssy signature below,1 hereby waivc t s requirement, l am the(check;�one) _ wner s agent,
R.hodV,.i°°vidA D pj,rtjxjeal, (If 1'fj ol� a ��
b vi4tc�a� c °�1r6rtti a c. Regt at;icm and`Safety'"
STATEIRE
EXPIRES:MM/2014"
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JOH'N BAR.ROS
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