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HomeMy WebLinkAboutBLDE-18-005850 - kttet Massachusetts Commonwealth of Official Use Only 4E Permit No. BLDE-18-005850 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] 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:4/20/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 294 OLD MAIN ST Owner or Tenant DARWALL RANDALL LEE Telephone No. Owner's Address 294 OLD MAIN ST, SOUTH YARMOUTH, MA 02664-4528 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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: Remodel kitchen bath room, dining room, &install su ihiiG,- Completion of the foils 4, s .. i1 4iis •e nee,.,.r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. I al Transfo r • • No.of Luminaire Outlets No.of Hot Tubs Generators grin /gip A ove In- No.of Emergency Liig=' No.of Luminaires Swimming Pool d. ❑ grind. ❑ y g Battery Unit No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 40 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 ❑ Other: Connection No.of Dryers 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 if 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: RICHARD G AYOUB Licensee: Richard G Ayoub Signature LIC.NO.: 28460 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 145 FLAVELL RD, GROTON MA 014501534 Alt.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: $75.00 'y /7rr �� �o nortucaLrr ol MO�sccL.-ScE6 07 * ',ZT Only R.=,--g� c� Permit No. e-mit, 2cp .r rr rt o/. -J crvi,:cs -�� - BOARD OF FIRE PREVENTION REGULATIONS-------- Occupancy and Fee Checked -�'G- 1Rev. 1/D7] (leave blank) APPLICATION FORIPERMIT TO PERFORM ELECTRICAL WORK All wort.to be performed in accordance with the Massaohusens Electrical Code(IvEC),527 CMP.1 LD0 (PLEASE PRLNT_INfOR TYPE ALL TN-FORMATION) Date: - V -2U/k City or Town of: RA/01-`I'E' To the Inspector of Wires: By this application the lindersicned glues notice of his or her intention to perform the electrical wort:described below. "t- Location (Street&Number) „2ci 4 DISC. Ma n St • Owner or Tenant R►(./1A✓,', Ay�h J Telephone No. ,/ _ 063 ' Owner's Address Is this permit in conjunction with a building permit? Yes ✓ No — (Check Appropriate Box) ,,,:za-- 4., Purpose of Building RertoJa �-C KA-cintan4 batliwwvv‘ Utility Authorization No, Existing Service gge>A ups /9 i 61.4JVoit Overhead ❑. Urdgrd No. of Meters New Service Amps-mps / Volts Overhead Undgrd _ No. of Meters Number of Feeders and Ampacity Location and Nature of I`t unused EIectrical Woric •sS 1 1)a� tgL� (p p ski hp A.-,e 1 i r k,l-rt,e,.i. Re w.. ._ _ _ -� In, ku hr, 10 co ke�.,,�,>tc( h..1-c�u.4.�+ b ,n�,►. e Completion of the forlowinz table may be w=ved by the Inspector of Fines. No. of Recessed Lnninal-es No. of Cer1--Susp.(Paddle)Fans No.°1 Total Transformers KVA No. of Luminaire_Onelets No.-of Hot Tubs Generators KVA No. of Luminaires S�Fimminc Above bi- .No.Di Emergency Lighting Pool ,rnd. ❑ _Fuld. ❑ Battery.Units No. of Receptacle Outset's No. of Oil Burners ik"11E ALARMS No. of Zones No. of Switches No. of Gas Burners Na.4 of Detection and I Iaitia zIIg Devices No. of Ramses Na. of Air Cond. Total Tons No,of Alerting Devices Heat Pump Number I"Tons KW .No,of .ell-Contained Totals: I IDetectionJAIertinE Devi No.of Waste Disposers ces No. of Dishwashers Space/Area Heating KW' Local Q Mturrcrpal Connection ❑ Order No.of Dryers Heating Appliances , Security Systems: No. of Water No.of Devices or Equivalent Heaters KWNo. of No. of Data Wiring Signs Ballast No.of Devices or Equivalent ' No. Hydromassage Bathtubs No. of Motors Total AP Telecommunications Wtrinn Na,of Devices or Equivalent i OTFFR: _ Attach additional detail f derired or as required by the Inspector of Fires. Estimated Value of Electrical Work: 6?5° (When required by municipal policy.) '' Work to Start: I S nspections to be requested in accordance with ivEC Rule 10,and upon completion. d 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 undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing om'c€w The 1n CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the a pims and ennlria �) rf s o perjury, that the information on this application is true an ' d complete; �-� FIRM NAME: ALL.-r-S t�e::...y1 LIC.NO,: Sig-nature -s Licensee: Si applicable, enter "exempt"in the license number line.) LIC.N O.: I f PP � Ras.Tel.No.Address: j Per NLG-L. c. 147, s-57-61,security Alt TeL No.: ty work requires Department of Public Safety"S"License: Lit.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage n— or y S required by la In sigma below,I hereby waive this requirement I am the(check one)❑ owner ❑owner's agent Owner/Agent 6 I Signature Telephone No. . I PERMIT FEE: $