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HomeMy WebLinkAboutBlde-20-002824 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-002824 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:11/14/2019 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 electncal work described below. Location(Street&Number) 6 NARROWS LN Owner or Tenant LUKE ARTHUR J Telephone No. Owner's Address LUKE CHRISTINA A,6 NARROWS LANE,SOUTH YARMOUTH, MA 02664-0100 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: Wire furnace&replacement heat pump. 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 Noy 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 1 No.of Detection and Initiatine 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: 1 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 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: PAUL J VIOLETTE Licensee: Paul J Violette Signature LIC.NO.: 20858 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 ANCHOR DR, FORESTDALE MA 026441822 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 14 -)212_ cif(c(Cgi r\ I 2,6,k //�� nw yy� C.omneusa�o!!//a�eackaisfla Official Use Only r■ !I . c� cc77 _ in_, Aparlrnsnl 0/3rs Service Permit No. �-- J =_'t;f _ e Occupancy and Fee Checked Spy BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07] (leave blank) .--- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical('ode(ME ).5 7 CMR 12.00 I(PLEASE PRINT IN INK OR TYPE ALI.INFORMATION) Date: i/ i 1-1il el City or Town of: re,it ri--)ou. 4-- Li To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electri al work described below. Location(Street& Number) Le ncAcrc ,s ! Owner or Tenant A - -VM L :.,t,t..s?_ Telephone No. Owner's Address .. Is this permit in conjunction with a building permit? Yes ❑ No © — (Check Appropriate Box) \i49 Purpose of Building / F.—A-t"i Utility Authorization No. V�*s� Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters _, New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters "� Number of Feeders and Ampacity 7 Location and Nature of Proposed Electrical Work: (,J c,re, ,cS FL,,.c-vi G�_ /- 214,/c c_ Completion 1 the followin&table may be waived by the inspector of H7res. 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 SwimmingPool Above ln- '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. Tons ``No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons ,KW No.of Self-Contained J Totals: Detection/Alertin Devices J No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other _ Connection No.of Dryers Heating Appliances KN' Security Systems: No.of Devices or Equivalent No.of Water K`,t, -No.of No.of Data Wiring: Heaters Ballasts Signs No.of Devices or Equivalent LI No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required hr the Inspector of Wires Estimated Value of Electrical Work: (When required by municipal policy.) 4 Work to Stan: 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 ..a-, the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coves force,and has exhibited proof of same to the permit issuing office. ACHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) a I certify,under the;Tins and penalties of perjury,that the information on this application is true and complete. ` FIRM NAME: Vi0/e,+.1-e- e"/ t:G ,}.-/-te, L.LC LI('.NO.: aURs-r4 7 Licensee: PCB,,,{ , 6 /4.,-Q- Signature f)Qµ.Q,t`1„,e -' LK:.NO.: i Ofapplicahle.enter "exam nt"in the license number line.I Bus.Tel.No,: 50 -.3 V Le-SS 7 — Address: 1 K 1 et-C1uY ()C Ara -�c3 S'4-3a t-Q-- 'It- 6 Ca`6'-( Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: t.ic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hare 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. Owner/Agent Signature Telephone No. PERMIT FEE: $