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HomeMy WebLinkAboutBlde-21-003384 Commonwealth of o � �«.���� Massachusetts Permit No. BLDE-21-003384fficial Use Only 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:12/15/2020 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) 109 NOTTINGHAM DR Owner or Tenant Steven Graziano Telephone No. Owner's Address 109 NOTTINGHAM DRIVE,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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Bond inground pool&wire equipment. Completion of the following table maybe 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 Inttiatine 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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: Douglas J Ahaesy )cd -77.4.-o(06,O Licensee: Douglas J Ahaesy Signature LIC.NO.: 20925 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:23 OLD PIERCE RD,23 OLD PIERCE RD,N DARTMOUTH MA 027471344 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 01 (K =--- nrJu` :hi ei-t. i2 L7'r1 i2. Lek /di;%/)ti-.- -rR , 00 r l(13,z1ki ZMek. c 2f— rF a_ C .o 114 i r Official Use Only Co'1) , o` aee.c�iaa.tts � c7 C --33 g2-4 �, �•= .,� �s k .tin. Permit No. ; i epa 0.1, ces r, �; .• � � �: r Occupancy and Fee Checked ><kt`S� f '' NTION REGULATIONS [Rev. 1/07] (leave blank) V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR 12.00 0 (PLEASE PRINT IN INK OR. PE ALL INFORMATION) Date: 121 /0 / 2020 J City or Town of: 1 c ?f\Ov.-A— To the Inspector of Wires: By this application the undersigned gives nnotice of his or her intention to perform the electrical work described below. .../ Location(Street&Number) 10 Cl � /0 ti s A( S h r . Owner or Tenant ..-re V e N C-rc 721 a Telephone No.S©k—y Z.4 y 34.Z J Owner's Address 4) Is this permit in conjunction with a building permit? Yes IE No ❑ (Check Appropriate Box) Q,) Purpose of Building r\-A)U , Utility Authorization No. v) Existing Service Amps / Volt, Overhead❑ Undgrd❑ No.of Meters v.) New Service Amps / Volts Overhead El Undgrd CI No.of Meters d Number of Feeders and Ampacity [ Location and Nature of Proposed Electrical Work:"Zion 1(/e i ,I k/ ro v N \ -1" (�U , cL G �� Mto 'i- you n Completion of the followin ta tra ble tray be waived by the! of Wires. Total No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans To.of Ti, Transformers KVA �1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA r1 No.of Luminaires Swimming Pool Above ❑ In- on No.of Emergency Lighting 4rnd. Ern& Battery Units ;‘1 No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and s Initiating Devices s 1' No.of Ranges No.of Air Cond. Ton No.of Devices Tons Alerting No.of Waste Disposers Hear) p Number TopsKW DerNo.of ctio Self-Contained otah: M No.of Dishwashers Space/Area Heating KW Local❑ Connnn/Aleriection 0 Other No.of Dryers Heating Appliances ICW Security Systems.* No.of Devices or Equivalent No.of Water I No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsofDevices r q Na of Devices or EqVaent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical Work: 3 0 0 0 (When required by municipal policy.) Work to Start: }2 I 2cvzo Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 E BOND 0 OTHER 0 (Specify:) I cerlffy,under the pains and penalty ofpesf+rry,thafthe information on this application is true and completes FIRM NAME: O c \ce.S fik.,A-es y 6 I'C(:'7"r. („,L C LIC.NO.:0 Z.O cj lS 4 Licensee: O W \c S \G a Signature L_.— LIC.NO.:S.03)d e (If applicab ,enter empP;in the lic lire.) M n oz-4,� Bras.Tel.No.;S'©CC= L6 01,40 Address:A 3 01 a \►e r C e 8. W A cr o u 1! 4- Alt.TeL No.: 'Per M.G.L.c. 147,s.57-61,security work requires Department ofPublic Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$