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REQUEST FOR ELECTRICAL INSPECTION
Failure to complete form may result in a delayed inspection
DATE_____________________ DATE FOR INSPECTION REQUESTED___________________
OWNER____________________________________________________________________
JOB LOCATION_______________________________________________________________
ELECTRICIAN & PHONE #_______________________________________________________
OWNER / ELECTRICIAN EMAIL __________________________________________________
DATE OF PERMIT APPLICATION (month/year) ______________________________________
TYPE OF INSPECTION
SERVICE ROUGH WIRE FINAL OTHER____________________
SPECIAL INSPECTIONS (requiring completion within 24 hours)
TRENCH (time trench will be open_______________)
REBAR (FOOTINGS) POOL
ADDITIONAL INSTRUCTIONS
SOMEONE WILL BE PRESENT NO ONE HOME, OK TO ENTER
COMMENTS_________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Town of Brewster
2198 MAIN STREET
BREWSTER, MASSACHUSETTS 02631-1898
(508) 896-3701 Ext 1127
(508) 896-8089 Fax
www.brewster-ma.gov
Email: building@brewster-ma.gov
Roland Bassett, Jr.
Wiring Inspector
Hours: 10:00-11:00 am Monday and Thursday