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HomeMy WebLinkAboutBLDE-22-003131 6 Commonwealth of Official Use Only t<0Massachusetts Permit No. BLDE-21-003131 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:12/2/2020 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) 80 CRANBERRY LN Owner or Tenant DUFFY ARTHUR J Telephone No. Owner's Address DUFFY TRACY A, 114 HUDSON ST, NORTHBOROUGH, MA 01532 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 of large room on back of house f 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 t, / KVA y� No.of Luminaires Swimming Pool Above 0 In- ❑ No.of E cy ( tp grnd. grnd. Batte Ct C, No.of Receptacle Outlets No.of Oil Burners FIRE ',�Y' . ' ,o e No.of Switches No.of Gas Burners No.of Detecti Initiatine Device Oe No.of Ranges No.of Air Cond. Total No.of AlertingDevices 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 ❑ 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: TODD A HIGGINS Licensee: Todd A Higgins Signature LIC.NO.: 13438 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1958, ORLEANS MA 026531958 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 Roc/&R ► f) --, KE-v 3 a c C�L� G ,/,mac-�/, //4� I U 4-i � 57 -_ Commonwealth of Massachuselfs • Official Use Only it—= —.t c7 r r. a�_; 1lapart`mcaE o{,yir��' Permit No.v�--1 arvicse - -- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev. 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 CAR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: // - 1-2 0 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) 30 C/ 40..//3C re-.0 .,Je Owner or Tenant 77_/&J/Z De, Z V / Telephone No. Owner's Address // /¢V.056,yU S.j.-2 n/v/Z77-430d20vC•yc yt61, Ois 3-2— Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) `� Purpose of Build ngg iL) LC:)'-- Utility Authorization No. Existing Service,&a Amps /LS /?3v Volts Overhead E Undgrd❑ No.of Meters ( New Service Amps / Volts Overhead❑ Undgrd l;r ❑ No.of Meters Number of Feeders and Ampacity n • Location and Nature of Proposed Electrical Work: /Z co(,./6 (-/ w t 2.1'1'1 C... C' L/3./4•C,C 0"41 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei7.-S (Paddle)Fans No.of Total �' Transformers KVA _ N No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- Zvo.of Emergency Lighting arnd. grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS lNo.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 iNumber Tons KW No.of Self-Contained Totals:I �- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KW No.of Data Wiring: 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: //- y 2--dlnspections 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. _T ErY ONE' SURANCE 2BOND ❑ OTHER 0 (Specify:) c4r400,F.tuor a pains and penalties of perjury,that the information on this application is true and complete. f`li'f NAME: 1 • )—// G G ij rJ LZL c..-772-!c-- LIC.NO.: /3 C L!ce �f i 0 i7 ,'�. /4>G(oi/�/S Signaturev �--�1� (If app'cable nt r " ©pt"in the licens number line) LIC.NO.:- �., ddresr._. rld$ —�g s— BUILDiiVi u C..0405 WA, (7?C Bus. By - e�� •�kL. 47,s.57-61,security work requires Department of Public Safe Alt.Tel.No.: URANCE WAIVER: I am aware that the Licensee does not have the liability Lin.No. S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner El o n— o — Owner/Agent ❑owner's a eat Signature Telephone No. PERMIT FEE: $