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17A-245 (12) / A - 00 1 2_k k 2-3 m OZI w-r\A-Q- Cam,, s p @C P L e— St-. tP '2u2L-144to OrtriAjCilen/Lger' Ste,-R`V\ k a 0 rn t '--7--- yy� ,. t1 o f/// Official Use Only nuntuut sa / aline uoth It A c�7j Apartment {{�� Permit No. 202z^/b 4o "_J partment ol..tires&mess � A. Occupancy and Fee Checked S j ',. I BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) °AP CATION FOR PERMIT TO PERFORM ELECTRICAL WORK c� All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR 12.00 (� (MEAS `P INT IN INK OR TYPEL INFORMATION! Date: , I $ a a mil C or Town of: �()( a� n To the ins ectdr o 'Wires: 'P . P By this application the u signed g'ves La his ontentio n to perform the electric !work describedbelow. Lam_. Location(Stiieet& mbcr) 'Ci l.lJt tTtu- N Q ( ftt 1 'IL)tn In I - Owner or Tuna Telephone No. C I_ q Ci Owner's Addr - .es) 4- r 100 ll\1\ Cl► D' V iIs this permit in con' ,rwith a building permit?A Yes ❑ N (Check Appropriate Box) Purpose of Buildings 1 W LA I (a D. Utility Authorization No. ExistingService 0 U ��lf •/ olts Overhead Undgrd No.of Meters r � ps � g ❑ I New Service 0 U Amps a 0 44 C)Volts Overhead ] Undgrd ❑ No.of Meters I Number of Feeders and Ampacity ,� n Location and Nature of Proposed Elects' al V4' • U'( LA plea( (:),004.1. •nn►pletion of the fallowing table may be waived hr the ln.cpector o/.Wires. No.of Recessed Luminaires o.o il., usp. dle)Fans No.of Total Transformers KVA No.of Luminaire Outlets ,'o. of Tubs Generators KVA No.of Luminaires S rming Pi.. la- ❑ No.of Emergency Lighting grn grnd. Battery Units No.of Receptacle Outlets No.o .a Bo ers FIRE ALARMS No.of Zones No.of Switches No.of Ga No.of Detection and i Total Initiating Devices No.of Ranges No.of Air Con•. Tons o.of Alerting Devices No.of Waste Disposers Heat Pump Num o s K No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating Local Municipal ❑ ,1❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of bevices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications t Iva No.of Devices or Equivalent OTHER: Attach additional detail if des iret/.or as required by the Inspector of Wires. Estimated Value of Etectr cat Work: V� (When required by municipal policy.) Q)Work to Start: I- I W-2j Inspecttons 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the informatiot on t is application is true and complete. FIRM NAME: JCamp Electric Inc. LiC.NO.:8214-EL-Al Licensee:Jesse Camp Signature �� LIC.NO.:22945-A (If applicable,enter-men in the li ►s n a►►he►•line.) / Bus.Tel.No.4132684224 Address: 6 Nash Hill FBI Williamsburg MA 0,196 Alt.Tel.No21133'85552 *Per M.G.L.c. 147,s.57-61,security work requires Department -.f Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare 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. Owner/Agent Signature Telephone No. PERMIT FEE:$ &O'