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HomeMy WebLinkAboutBlde-19-006196 ' � ` ') Commonwealth of Official Use Only or�..p,�� Massachusetts Permit No. BLDE-19-006196 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK j All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 1-- (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:5/1/2019 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) 21 CARVER RD Owner or Tenant WAITE STEPHEN G Telephone No. Owner's Address WAITE THERESA,9 BROUSHANE CIR, SHREWSBURY, MA 01545 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel house. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 24 No.of Ceil:Susp.(Paddle)Fans 2 No.of Total Transformers KVA No.of Luminaire Outlets 32 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 54 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 36 No.of Gas Burners 2 No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump _, Number, Tons KW No.of Self-Contained 10 _Totals: Detection/Alertinc Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 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 Siens 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 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: Sean G Willis Licensee: Sean G Willis Signature LIC.NO.: 10439 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 SHERRIFS LN, EAST SANDWICH MA 025371365 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 �� b aZ 6g/lQ�, 71/�} 114 • © p 1 ' t LA (3 r S Zoucit "' 2> 1p//3j19off- ue mar 4 24 n 7,:3 0747(�� 7\ 1 9 t 3(el te < `l �OI7tI7i01Lrl/tQLL�'R ofgssacl • Offic�iall Use /Only,�Q �1= eparlmaat o firs J Permit No. arviaed f {R BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked "'�'`� ev. Ur) (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C e(MEC),527 CMR 12.D0 LO (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / f ZO/? City or Town of: BythisYARMOUTH ` To the Inspector of Wires: application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) Z i Ca/Vef— E0. Owner or Tenant STeD ev GJc..& Telephone No. _. _g .py •g ,m; - 1. Owner's Address Los z reie, Sirt_c.0 b(,t i MA 015 r Is this permit in conjunction with a building permit? Yes Wol No g : Purpose of Building 1���„ (�, Utility ❑ (Check Appropriate Baz) Authorization No. V M Existing Service /d() p m j w/ zt/�olts Overhead Undgrd / ' gr ❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd gr ❑ No.of Meters . _____ , .. Number of Feeders and Ampacity Z A /O0A Location and Nature of Proposed Electrical Work: b )) /� e(F 40� i/irL Td� AovS� r71r�^p Completion of the following table may be waived by the Inspector o Wues. - No.of Recessed Luminaires Z 4 No.of CeiL-Susp.(Paddle)Fans a No.of Total Transformers -� KVA No. of Luminaire Outlets 3 Z No.of Hot Tubs O Generators ,.t T KVA No.of Luminaires 5-6 Swimming Pool Above In- No.of k,mergency Lighting - _rnd. grad. 64 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches 36 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges /- 3 No.of Waste Disposers �' No.of Air Conti Toss No.of Alerting Devices Heat Pump Naq er To �K No.of Self-Contained /D rTotals:I i'J ` - `Detection/AiertingDevices ` No.of Dishwashers Space/Area Heating KW l❑ Municipal 1Loca Connection ❑ Om=r No.of Dryers I Heating Appliances"er K, Security Systems:* Na,of Water No.of Devices or Equivalent No.of Heaters .9" KWNo.of Data Wiring: ell 11 Signs -0- Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs , ' No.of Motorse Total HP Telecommunications Wiring: ® OTHER: No.of Devices or Equivalent — (I 'DO Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value o c ' al Work: /`6 V (When required by municipal policy.) Work to Start: I ZO(7 Inspections to be requested in accordance with MEC Rule 10, on. INSURANCE CO E GE: Unless waived by the owner,no permit for the performance of electrical work maytissue 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 ld BOND ❑ OTHER ❑ (Specify:) -- I certify, under the p3ins and en qls of per ry,that the information on this application is true and complete 3 FIRM NAME: ,//,'5� tiecIrr'efaci c LIC.NO.• l /� Licensee: cCet/1 !/ t.s Signs e ,eG.- ,4deC- LIC.NO.: (If applicable,enter" empt"' e 'tense numbg�'!inf.) Address' /(� Q/,' tee CGS �� 53? • Bus.TeL No.: IZ J `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.Tel. . — OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally ally 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner Cl owner's a eat. Owner/Agent Signature. Telephone No. . PERMIT FEE: $ 7