HomeMy Public PortalAboutElectrical Application revised 2-1-16 - Page 1_201602191410395247Date Received:
Town of Watertown
Building Inspection Division
149 Main St.
Watertown, MA 02472
Tel: 617-972-6480 — Fax: 617-926-7778
Date
The Commonwealth of Massachusetts
Department of Public Safety
Board of Fire Prevention Regulations 527 CMR 12:00
Office Use Only
Permit No.
Application Fee
Check #
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit
Yes 0 No 0
Purpose of Building
If residential dwelling, No. of Units
Existing Service
Eversource #
Utility Authorization NO.
Amps / Volts Overhead 0 Undgrd 0
No. of Meters
New Service Amps
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total KVA
No. of Lighting Fixtures
Swimming Pool
Above Grnd. 0 In-Grnd. 0
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Ranges
No. of Air Cond. Total Tons
No. of Detection and Initiating Devices
No. of Disposals
No. of Heat Pumps
Total Tons Total kW
No. of Sounding Devices
No. of Dishwashers
Space/Area Heating kW
No of Self Contained Detection/Sounding Devices
No. of Dryers
Heating Devices kW
Local 0 Municipal Connection 0 Other
No. of Water Heaters kW
No. of No. of
Signs Ballasts
Low Voltage Wiring
No. Hydro Massage Tubs
No of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed
Operations Coverage or its substantial equivalent. YES 0 NO 0 I have submitted valid proof of same to this office. YES 0 NO 0
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE 0 BOND 0 OTHER 0 (Please Specify)
Estimated Value of Electrical Work $
Work to Start
Signed under the penalties of perjury:
FIRM NAME
(Expiration Date)
Inspection Date Requested: Rough Final
LIC. NO.
Licensee Signature LIC. NO.
Address
Zip Code Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by
Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner 0 Agent 0 (Please check one)
Bus. Tel. No.
******Before changing any service or any meter work, please notify Eversource for
service drop, meter location & authorization at 888-633-3797*******
Volts Overhead 0 Undgrd 0
No. of Meters
TOWN OF WATERTOWN
Phone: 617-972-6480 fax: 617-926-7778
149 Main St., Watertown, MA 02472
ELECTRICAL FEE SCHEDULE
(Effective September 30, 2013)
EXISTING DWELLING SERVICE INDUSTRIAL/COMMERCIAL
Initial Fee 25.00 Initial Fee 50.00
$30 per $1,000 or part of up to $5,000.
(Then)
$15 per $1,000 over $5,001.
Residential/Industrial/Commercial:
Occupancy Permit Fee 25.00
Reinspections 25.00
Single Appliance replacement 20.00
Electrical Work Siding 20.00
Alarms 50.00
Minor repairs 20.00
Off hour shutdown 1-4 hour standby 400.00
$30 per $1,000 or part of up to $5,000.
(Then)
$20 per $1,000 over $5,001.
Annual Permits 150.00
Reinspections 25.00
Prepaid to Town
Non -access to site for inspection will
Require reinspection fee
CHAPTER 143, GENERAL LAWS
Section 3L. Regulations relative to electrical wiring and fixtures; notice of electrical installation.
No person shall install for hire any electrical wiring or fixtures subject to this section without first or within
five days after commencing the work giving notice to the Inspector of Wires appointed pursuant to the
provisions of section thirty-two of chapter one hundred and sixty-six. Said notice shall be given by
mailing or delivering a permit application form prepared by the Board, to said inspector. Any person
failing to give such notice shall be punished by a fine not exceeding five hundred dollars. This section
shall be enforced by the inspector of wires within his jurisdiction and the State Examiners of Electricians.
Fee doubled if permit not filed in a timely manner.
This side for Electrical Inspector Report of Inspector of Wires
Service Conduit Size
Service Conductor Size
Service Switch Amps
Notified Edison:
Date Who Notified
Rough Final
Job Final