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HomeMy WebLinkAboutBlde-21-001633 Commonwealth of Official Use Only ° 0Permit No. BLDE-21-001633 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:9/29/2020 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 Co described a ow. / Location(Street&Number) 49 MAINE AVE K�/ L/,s 2 Owner or Tenant ELLSWORTH PHILIP J Telephone No. Owner's Address ELLSWORTH JOAN A,257 SOUTH SEA AVE,WEST YARMOUTH, MA 02673 � r I Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr6gic?a)e ' 1 x) f23 Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 `` i • •r. tt New Service Amps Volts Overhead 0 Undgrd 0 . ..o ,I Number of Feeders and Ampacity 4 &P' Location and Nature of Proposed Electrical Work: Wiring of basement for two rooms&bath room. U Completion of the following table maybe waived by • ..• • . Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting god. 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 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: 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 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: 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: Jared P Macdonald Licensee: Jared P Macdonald Signature LIC.NO.: 14854 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:809 Scenic Hwy, Buzzards Bay MA 025322202 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 G V 3a/.7"° RO66f(Rej,i' 1.h'z'l24 Ke (1-41124-14r eouozyz 4 spU de M/1) -up) kW , Vucb ID arb 0 erelb ON g � 3I 1 , I ) 4 ., Cof tty Official Use Only Commonwealth ad�ac 7 A F ,. t _ --A — t 3 a_ ,_' cx Permit No. —'- '_ 2 artinerd .gire Serviced = _=t�- Occupancy and Fee Checked 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 Codep( ), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: I ge- O City or Town of: 0.,(tvto « To the Inspector of Wires: By this application the undersignea gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) y q I t l o,.,x_ , Pt1/..L_ Owner or Tenant F (13 ,u3D r 4-1,‘ , Ph., I k, Telephone No. Owner's Address Y Is this permit in conjunction with a building piermit? Yes CO No ❑ (Check Appropriate Box) Purpose of Building R 05 1 (4,P vck OA Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ice.) ` As C, A ,cLisiIt7ci5re v n\--- Completion of the followingZtable may be waived by the Inspector of Wires. NoTotal No.of Recessed Luminaires No.ofCeii.-Sus .(Paddle)Fans Transformers of KVA P KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmingpool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zonesof No.of Switches No.of Gas Burners No. Initiatinnggon Dete and In 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 P Totals: -.. Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ Municipal 0 Other P Connect on No.of D ers Heating Appliances KW Security Systems:* �'Y No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNDevicesor Wiring Y g No.of Equivalent OTHER: Attach additional detail if desirecl or as required by the Inspector of Wires. Estimated Value of lectri al Work:9 LI )CD (When required by municipal policy.) Work to Start: ?ff ao Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 roz BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of pe ury,that t e information on this application is true and complete. FIRM NAME: 3&r) P. � ' c 1 C 1,(,t - f,L vc& LIC.NO.: I L( P.S Li Licensee: 6()_rp c Q. I Ili c-�jth (k_ Signature te irK i�C... LIC.NO.: / N g SLJ (If applicable,enter "exempt"in the license umber line.) Bus.Tel.No.: 7 7 q $.31e (0033 Address: MCI S t.P_� <t - Vti.1 QDuJ' � Oa'5.3 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work re4uires 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 PERMIT FEE: $ Signature Telephone No.