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HomeMy WebLinkAboutblde-20-000004 or F Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-000004 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:7/1/2019 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) 62 KEEL CAPE DR Owner or Tenant MOORE BARBARA L Telephone No. Owner's Address 62 KEEL CAPE DR, SOUTH YARMOUTH, MA 02664 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: Wiring for new bathroom. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Richard T Mckenzie Licensee: Richard T Mckenzie Signature LIC.NO.: 28006 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 BARQUE CIR, SOUTH DENNIS MA 026602359 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 C c,,___ /9 Q r� N., ga , /,' 007:0' a - _ C.omewrrm of///assarlf5 Official Use Only =�' _ 2epar rt o f. re S Permit No. C—'[.d t�tfl� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '�,` (Rev. 1/07] (leave blank) 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: ^v2 f City or Town of: YARNIOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or intention perform the electrical work described below. Location(Street&Number) b �o e/ .. Owner or Tenant 4/, 6 47,.a_ /:®Se.,1/ Telephone No. Owner's Address Is this permit in conjunctio building with a '►' permit? Yes No ❑ (Check Appropriate Box) /C.£� Purpose of Building i t�4ir-t e- Unlit' uthorizatlon No. Existing Service /�O Amps /,�j / Z� Volts Overhead Und grd❑ No.of Meters / New Service Amps / Volts Overhead❑ Undgrd 1'T ❑ No.of Meters Number of Feeders and Ampacity %CC) Location and Nature of Proposed Electrical Work: ��< 417-;(9 , Completion of the following table may be waived by the Inspector of Woes. No.of Recessed Luminaires No.of Cer1-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 i.mergency Lighting =Ind. arnd. Battery units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW 'No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection 0 Other No.of Dryers Heating Appliances KW, Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: . OTHER: No.of Devices or Equivalent Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of,Electrical Work (When required by municipal oli Work to Start: a-d2�a � P �'•) 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 • the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L BOND ❑ OTHER 0 (Specify;) L, e/ is FIRM NA under the and Penalties of erju ,that the information on this application is trice and complete. G.s- .eirrlre_ ej'e..- Ec LIC.NO.: ' f ' , //fie -_ YS 1 Si slur LIC.NO.: Licensee: _� (If applicable,enter "er t in the 1 rue tuber li Address: /e r Bus.Tel.No.: C/ J `Per M.G.L. c 147 s ®�s2e5 /� 61,security work requires Department of Public Safety- Alt.Tel.No.: OWNER'S INSURANCE WAIVER: "S"License; Lic.No. required I am aware that the Licensee does not have the liability insurance cove 5 Ownr Agent By my signature below,I hereby waive this requirement. I am the(check one rage owner's ally I ISignature �owner ❑owner's a eat. Telephone No. PERMIT FEE: $ gZ2 . if- 0o7a10 l©/, 6 3 Cnmnionantalth of///addae Official Use Only i=." __ _.� c�77� 811 = -camLJeparfinent of.,y-ire Serviced Permit No. _ ` -- ` BOARD OF FIRE PREVENTION REGULATIONS , .Ovary• and Fee Checked _ ._,. 1/07] cave blank 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: , ^v2 ._ City or Town of: YARMOUTH — By this application the To the Inspector of Wires: undersigned gives notice of his or intention tp perform the electrical work described below. Location (Street&Number) b /le e/ ,e ,!✓\,.1/4. Owner.or Tenante4-,6422cQ Zvse.� Telephone No. Owner's Address Er Is this permit in conjanctio with a building permit? Yes ❑/ Purpose of Burldntg /C���'t�e�C G, N0 ❑ (Check Appropriate Box) Utility}...uthorization No. Existing Service /50 Amps 40 / 249 Volts Overhead Undgrd ❑ No.of Meters P New Service Amps / Volts Overhead 0 Und grd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: GP/< ACC) �G�,e /,%fL Completion of thefollowing table may be waived by the Inspector of Wires. - No. of Recessed Luminaires No.of Ces1.-Susp.(Paddle)Fans No.of Total Transformers KyA No.of Lum,aaire Outlets No.of Hot Tubs K - Generators VA No.of Luminaires Swimming Pool Above ❑ In- 0 No.of L.mergency Lighting =sd- nand. Satterp Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas BurnersNo.of Detection and - initiatiks Devices No.of Ranges No.of Air Coed. Total - Tons No.of Alerting Devices 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 Q Municipal No,of Dryers Hear A Connection 0 Other gAppliances ecurity Systems: No.of ater No.o Na of Devices or E • alent Heaters ' o.of Data Wiring: Signs Ballasts No.of Devices or uivalent NoO . Hydromassage1"t1>✓R: Bathtubs No.of Motors Telecommunications Wiring Total HP No.of Devices or uivalent k Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of.Electrical Wor Work to Start:A. -�. � (When required by municipal policy.) _ I INSURANCE COVERAGE; Unlesss ections waived to be by the owner, perin mit for theperformance ce with AEC Rule 10,and upon completion. the licensee provides proof of liabilityinsuranceof electrical work may issue uriless including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such c,�ov,�e�is in force,and has exhibited proof of same to the permit issuing office. C\ CHECK ONE: INSURANCE L1� BOND ❑ OAR 0 (Specify:) r; I verb}', under the and penalties o f fY) (9�i application � ce Al �\ FIRM NAME: f,erj ,[hat the information on this application is and complete. rat .e�1e_ , MP / Licensee: ej'�'0 LIC.NO.:,��tb (Ifapplicable enter ez Sigrrahir _ - � t to the 1 rise r�umbe�li LIC.NO.; Address.'/ r Je `Per M G.L +�� �— /I®�•.�r5 Bus.Tel.No.: �� _ (� xr 61,security work requires Department of Public Safe .S" Alt TeL No.: �� l(� C Q Per M. 'S INSURANCE WAIVER: Safety` License: Lic.No. `v I am aware that the Licensee does nor have the liability insurance cove��- rOwnrrdAyen[. By my signature below,I hereby waive this rage normally requirement I am the(check one ❑owner Signature owner's eat '�1 Telephone No. PERMIT PPR! .g