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HomeMy WebLinkAboutBlde-22-002318 Commonwealth of Official Use Only fisp, Permit No. BLDE-22-002318 Ewa VA Massachusetts 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:10/22/2021 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 de bed below. Location(Street&Number) 34 LIVERPOOL DR S—'4(214 E( LONRAI) r F042tA Owner or Tenant W ) Telephone No. Owner's Address W 4 LIVERPOOL DR,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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: Rough,finish, &underground for wiring new studio. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 2 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 5 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices 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 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 Ballasts Data Wiring: Heaters Siens 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 ❑ 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: Lanzoni Anderson Signature LIC.NO.: 57432 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 176 Hinckley Road,Hyannis MA 02601 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. IPERMI?e-v-6/4 f 11111111111W- 1 L t k 1 - til4z-1 KE-- , '' .-TMoit, cl 2ct zc w__ A-061/01,60 p,4f,._b Commatuveaa o`maeeac�iaeette Official Use Only 2�4 S Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07) (leave blank) 0 '.....4 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 72PE ALL ORMAT7ON) Date: h o) 2'L 12a 2'. City or Town of: y Amou14 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) `)L Li v Pno L t'R t_ y,4U o UT�f t(A Owner or Tenant �j4 ^J QPr/\..c t%i2M Telephone No. 546 5415"4So9 Owner's Address 31.1 l.i Ve7a PO&L IV 1 yifPh(14U7.14 M.4 N Is this permit in conjunction with a building permit? Yes [2] No 0 (Check Appropriate Box) '.� ' Purpose of Building R ESj Ivkir J L. Utility Authorization No. KLD-21-00 5 6,l( Existing Service-A0© Amps 4.2D/2Lio Volts Overhead❑ Undgrd[( No.of Meters Pa_ tNew Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters bNumber of Feeders and Anspacity ', Q.. Location and Nature of Proposed Electrical Work: Eu EQ C;Y312 i r)& rM.(E Ne ln/ Ail r s nt 1h iD ( Q:)1Ji,06 .. A. t1 tJ b et ari tliJ D 2oA- FieD A►)p G;N Sal tNG rti e vPAc P, WI?'Akre e 2 i rJ ch cri or4. wl Completion of thefollowingtab$ rmers be waived by the I of Wires. tl No.of Recessed Luminaires 0 Z No.of Ce9. Fans'���le) T KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4 No.of Luminaires Swimming Above ❑ In- ❑ Battery of>Units ncy Lighting Pool grad. gent. Battery Unit: J No.of Receptacle Outlets Os No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 03 No.of Gas Burners No.of Detection and Initlatina Devices Ili No.of Ranges No.of Air Cond. T n�i No.of Alerting Devices No.of Waste Disposers Heat T� Number Tons KW _No.of Self-Contained No.of Dishwashers Space(Area Heating KW Loci 0 Connection 0 Other No.of Dryers Heating AppliancesKW tecuNo.ofSl�or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Sins Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tdecommunications No,of Devices or Ect ent OTHER: Attach additional detail fjdeiired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (4. 9 20-0 0 (When required by municipal policy) Work to Start: ko 12 /2024. 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 cevpnge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 2 BOND 0 OTHER ❑ (Specify:) I certtjy,under the pains and penalties of pletjwy,that the information on this r is true and cow FIRM NAME: A t.SDN .4L6ariN 1 �M LIC.NO.: 5-3-4 32-8 Licensee: Signature g L.te � U17�u(1.,. LIC.NO.: (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public 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)❑owner 0 owner's agent. Owner/Agent S PERMIT FEE:$ 50.00 Signature Telephone No.