No preview available
HomeMy WebLinkAboutBLDE-22-003038 co pq. Commonwealth of Official Use Only f�` Massachusetts Permit No. BLDE-22-003038 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:11/24/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perf rm the electrical work described below. Location(Street&Number) 18 NICHOLAS DR I G�L 774'OMV�k) Owner or Tenant MEEKS JOSEPH L JR Telephone No. Owner's Address 18 NICHOLAS DR, YARMOUTH PORT, MA 02675 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: Replacement HVAC. 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 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 ❑ 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 Ballasts Data Wiring: Heaters Sims ,No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: , . No.of Devices or Eauivalent 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: James M Venuti Licensee: James M Venuti Signature LIC.NO.: 15798 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 JOSIAHS PATH,W BARNSTABLE MA 026681340 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 my 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: $50.00 Commonwealth of hicre3acl~ a e Official Use Only � Permit No. - -3°38 r ' � �cpael+:unc or APC Sept/ices- 1 . '- - 5 Occupancy and Fee Checked `-.•�„ BOARD OF FiRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) j o�� � `L f ice.�--- f .� £, s f i=la: `:is• T T^ �-E J-=. ,L -.� [: U v J y e :A.0— K All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR i2.00 (PLEASE PRINT IN INK OR TYPE ALL IIt'FORAIATION) Date: ////6/Z 1 City or Town of: "c very? 4 TV1 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street Ni/ . Number) I B / v J O l .s Dr--1 Owner or Tenant fii lc " 0"n105atl Telephone No.967-( 5S-ZZ-IV Owner's Address is this permit in conjunction with a building permit? Yes ❑ No (Vr. (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps l Volts Overhead n U dgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undg_d n No.of Meters Number of Feeders and A?npscity Location and Nature of Proposed Electrical Wok:st: �Vj4L 41 G_tOI ecc,v ici1 1 1 Completion of the following table may be waived by the Inspector of Wires. INo.of 'rote! No.of Recessed Luminaires INo.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Lr<Ftir±e6re cutlets No.of riot€ribs Generators Fa''/' Above in- IVO.of emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets INo.of Oil Burners .FIRE ALARMS f No.of Zones f 1No.of Detection and INo.of Switches INo.ofG>s Burners g initiating Dervices tal No.ofRanges J No.of Air Cond. TOM No.of Alerting Devices f jl Heat ump Number i i oats __ `No.of Self Coatsined r?o.of Waste Disposers i otal;s: IDetectionJAlerting Devices No.of Dishwashers Sp$ce/A rea Beating KW fruoc8l❑ nn�ec ion iFil ❑ O Sec rep a Systems:- No.of Dryers r fleeting Appliances ri' I No.of Devices or Eouivalent No.of Water , No.of No.of Data Wiring: Resters E=e ' Ballasts No.of Devices or Equivalent _ Signs Telecommunications Wiring: No.Ilydromassage Bathtubs INo.of f�Eators Total t-IP No.of Devices or Equivaent 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 Stan: Inspections to be requested in accordance with MEC Rule 10,and upon completion. ?NSURA NCE 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 ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,ender the pains and penalties of perjury, that the information on this application is true end complete FLRMNAME': _.1)c_inn.:_5 AVA . I;:_e:v'FT e.[w ,';'<- � T,:. - 7' - L?C.NG.: A-15-7 Licensee: .77v:- _S .'L'l: (irns. Signature U'�'LU/v LiC.NO.: Of applicable.enter "exempt"in the licen�e number line.) ,. Bus.Tel.No.:�t� -''jZ -7?G' Address: 2.i, ._ c� i=lams %� 'ram (N t' t�.i Ss�h IC M i G 2 &6 Alt.Tel.No.,5bT-i'a`1E-5136.f. 'Per M.G.L. c. 147,s 57-61.security work requires Department of Public Safety"S"License: 1_ic_No. OWNER'S [NSEJRA_NCEWAIVER: i am aware that the Licensee does not have 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. Sger/.=gent 1 ER IT FEE: 1 gignt,gEure Telephone No. l _- !:i`V r l t- Izr-ty i i er ',=..0 . L c-,— f