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HomeMy WebLinkAboutBLDE-19-1509 RP\ EI a. / Commonwealth of Official Use Only /E•.Tf� Massachusetts Permit No. BLDE-19-001509 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/07j APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/13/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work descri� d,�law. e---a(2-1 Location(Street&Number) 54 SCHOLL AVE AA/ 1"l C U C Ness Owner or Tenant QUINN JOHN E ESTATE OF Telephone No. Owner's Address MCGUINESS ANNE J EXECUTRIX, 16 SUMMIT RD,NAUGATUCK,CT 06770 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters • New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&install wiring for dryer. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail((desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to start: Inspection 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: NICHOLAS MCELROY Licensee: NICHOLAS MCELROY Signature LIC.NO.: 53797 (If applicable,enter"exempt'in the license number line.) Bus.Tel.No.: Address:8 Blackthorn Path,Forestdale MA undefined Mt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 & c/zy1/s \k-IU U ' � amino. nivran.h of st/aasac fil Official actUse Only m ..UrPar[msnt c f-tirr J �o 3 ci =Yip Permit No. rwiut _- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked • ev. 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 5 7 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I/ City or Town of: YARMOUTH To the Inspector of Wires: a . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 54 Sho\1 Ave d Owner'or Tenant tfi nt\, At:r7airtcsS Telephone No.,203 9jo -;t$ON Owner's Address SH ON°kl O\,V e Is this permit in conjunction with a building permit? Yes 0 No Ere (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service I(T.7 Amps lit / Volts Overhead 121Undgrd❑ No.of Meters I New Service I IX' Amps 1 "/ Volts Overhead u Undgrd 0 No.of Meters 7— lib Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ned met, e..,\e_4 t•,c..\ SCc V,c{, c u.At e Nitta- ON c/ Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL Snsp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above 0 In- No.of Emergency Lighting grnd grnd 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained s Totals; Detection/Alerting Devices SNo.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection 0 Other T No.of Dryers Heating Appliances KW Security Systems;* — © No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: 6 No.of Devices or Equivalent • 3 OTHER: _ — Attach additional detail Vdesired or as required by the Inspector of Wires. 4 Estimated Value of PethiFal Work: (When required by municipal policy.) Work to Start: 9/19 Ile e Inspections 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 Jo the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEtr BOND 0 OTHER 0 (Specify:) f crab', under the airs a(n�d penalties of perjury/,�that the information on this application is true and complete. 7 FIRMNAME::►-77 f tth M(Ct(1 t-1ec41:itinn LIC.NO.: Si7g1�3 Licensee: Mal MU-7I' / Signature LIC.NO.: (If applicable,enter"exempt"in the flame number line.) u Address: I 1 t aun S (C I /An&4ons ANAlt.IS 1 Bus.Tel.No.: Cvk- 66- j Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie No. 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 ❑owner's agent t Owner/Agent Signature Telephone No. 1 PERMIT FEE: $