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HomeMy WebLinkAboutBLDE-20-001063 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001063 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:8/26/2019 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 described below. Location(Street&Number) 39 DANBURY ST Owner or Tenant YENULEVICH MARY Telephone No. Owner's Address TELFORD STEVEN, 39 DANBURY ST, 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 ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire house. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 16 No.of Ceil:Susp.(Paddle)Fans 3 No.of Total Transformers KVA No.of Luminaire Outlets 3 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 42 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 18 No.of Gas Burners No.of Detection and Initiating 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 Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal ❑ 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 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: Licensee: Leandro Amanco Signature LIC.NO.: 56103 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Mansfield Ma 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: $460.00 C.IteCr € 'I t 9 (641-0 [r./4z &ye/galled o��C Cominorwisa[Ih of I//assac Its • Official Use Only 0 z _ 2eparl+nant o f.firer Serviced Permit No. ��r-C 6 Gp3 Occupancy and Fee Checked Lu i o, s Li ' `= BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) > l i w APPLICATION FOR:PERMIT TO PERFORM LI 1 All work to be performed in accordance with the Massachusetts ElectricalELECTRICAL WORK Cc'; cD ;z LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date '527 CMR 1 z.00 w L .< City or Town of: yARMOUTH To the Inspector of Wires: e� i m r y this application the lnmdersigned gives notice of his or her intention to perform the electrical work described below. ocation(Street&Number) 3q ( N 6U T ©u1 • itkMO 174 m4 L Owner or Tenant YEivuLEVcct-t f Telephone No. l Owner's Address 5 AltA,45 Is this permit in conjunction with a building permit? Yes Nr No ❑ (Check Appropriate Boz) Purpose of Building g_es 1'AtUtility Authorization No. Existing Service in Amps jolt/d21q(Volts Overhead Undg rd❑ No.of Meters 7 New Service , f 1) Amps IA/0140Volts Overhead[V Undgrd t;r ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: AU ntew w L N c Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires l No.of Cem1.-Susp.(Paddle)Fans No.of Total 3 Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 3 Swimming Pool Above ❑ In- No.of Emergency Lighting - Qrnd.. srnd. ❑ Batter7 units No.of Receptacle Outlets L1 a No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches I g' No.of Gas Burners • No.of Detection and Initiating Devices No.of Ranges I No..of Air Cond. ta Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:l I �_ Detection/Alerting Devices Na.of Dishwashers 1 Space/Area Heating KW Local❑ M ionunicipal Connect ❑ Omer No.of Dryers I Heating Appliances KW Security Systems;* No.of Water No.of No.of Devices or Equivalent 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 t Attach additional detail(desired or as required by the Inspector of Wires. Estimated Value f El trical Wort ' (When required by municipal policy.) Work to Start: off! 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Sill BOND 0 OTHER I cent)", under the pains and penalties o u ❑ (Specify:) p fperi perjury,that the information on this application is true and complete. FIRM NAME: L6/j/ MA A) 1 Licensee: LIC.NO.: (If applicable,ern -exem Signature LIC.NO.: p ' in[he licerts S tuber line) Address: l Lit v V Bus.Tel.No.: qa5 ,l "Per M.G.L. c. 147,s.57-61,security work require Department of Public Safe Alt.Tel.No.. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not havethe Lic.No. required by law. By my signatureliability insurance coverage normaally— Owner/Agent below,I hereby waive this requirement I am the(check one []owner ISignature ❑owner's a eat Telephone No. PERMIT FEE: $ 600 `f'-