16B-058 (6) 10 HAYWARD RD
/6.e- oQ-60/
Subject: 10 HAYWARD RD
From: "Wendy - AK Electric, Inc." <wendy@akelectric.us>
Date: 5/19/2023, 11:08 AM
To: Beth Willard <bwillard@northamptonma.gov>, Jason Wolfe <mostbuilders@gmail.com>
Good morning Beth:
We would like to withdraw our electrical permit for 10 Hayward Road as the contractor has decided to
go with another electrician.
Regards,
Wendy Fortin-LaRocque
AK Electric, Inc.
413-530-7845
1 of 1 5/19/2023, 11:12 AM
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41► official use only
Commonwealth of Massachusetts Permit No.: I9_�,Q 23 -D�72
3 '' Department of Fire Services Occupancy and Fee Checked:le�D'?2
5 --. a - 'RD OF FIRE PREVENTION REGULATIONS [Rev. l/2023]
- ' ' ' PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
o 0_,_ okll wok be performed in a ordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
o- ity or Tow Fri k • ■alit - • Date: 04/27/2023
y,..,x,,+,, i it :y this application,the undersigned gives notices of his or her i tention to perform the electrical work described below.
N
Locatio ','r:r. Aral tuber): 10 HAYW A
'D Unit No.:
.-finer or Tenan• A - ' - E 1:
Owner's Address: 10 HAY —D D RD Phone No.: -297-2692
Is this permit in conjunctio i ' ith a building pe ' . (Check appropriate box)Iles 0 No 0 Permit No.:
Purpose of Building: RE.IDENTI Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground 0 'No.of Meters:
New Service: Amps / Volts Overhead❑' Underground❑ No.of Meters:
Description of Proposed Electrical Installatio • AT H R O O M REMODEL
Completion of the following table may be waived by the Ins ctor of Wires.
No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminai . N . ind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: ransfomrdrs: Total KVA:
Space Heating KW: Heating Equipment K • No.Motors: Total HP: Total KW:
• No.Heat Pumps: Total KW: Total T : Fire Ala S stem 0 No.of Devices:
Swimming Pool:In-Grad.0 Above-Gmd.0 H ' ub 0 e. lf.Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: — Video System No.of Devices:
No.Air Conditioners: Total Tons: Telecom System No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Se ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: Ns,No.of Electric ehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount 0 11❑ el 2❑ Level 3❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: en required by municipal policy)
Date Work to Start: Inspections to be reques m accordance '+ u 10,and upon completion.
FIRM NAME: AK ELECTRIC. INC. A-1 —1❑LIC.No.: 940-EL-Al
Master/Systems Licensee: SCOTT KIBBE C.N • 7504A
Journeyman Licensee: C.No.:
Security System Business requires a Division of Occupational Licensure"S"LIC. S-LI .
Address: 345 Wilbraham Street, Palmer. MA 01069
Email: wendy@akelectric.us Telephone No.: 413-2 -6876
I certify,under t pains an allies of perjury,that the information on this application is and co plete.
Licensee: 4i Print Name: Scott Kibbe Cell. o.:4 I -99 0
INSURANCE COVERA :Unless waived by the owner,no permit for the performance of electrical wo y• e unless the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersi ifies that such coverage
is in force and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE® BOND❑ OTHER 0 Specify:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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 0 Owner's agent 0
Owner/Agent: Tel.No.:
Signature: E il.: