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HomeMy WebLinkAboutBLDE-22-006744 tij Commonwealth of Official Use Only / (::kli Massachusetts Permit No. BLDE-22-006744 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:5/23/2022 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. A `\Q1 12. Location(Street&Number) 10 BERWICK RD Owner or Tenant NOLAN JOAN A TR Telephone No. Owner's Address THE J A NOLAN TRUST, 11 COUGHLIN RD, NORTH EASTON, MA 02356-2007 .. Is this permit in conjunction with a building permit? Yes 0 No 0 (C • --'':VW' Purpose of Building Utility Authorization No 7 to`;-.. t Existing Service Amps Volts Overhead 0 Undgrd 0 .. r ' e ers New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence.(Modular) 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- ID No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and 1 Initiating Devices No.of Ranges No.of Air Cond. 1 To 1 No.of Alerting Devices 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 ❑ 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 Signs 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: Eric J Sylvia Licensee: Eric J Sylvia Signature LIC.NO.: 13901 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 LAUREL ST, FAIRHAVEN MA 027193836 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:$180.00 '© (66fli),An> 4. > ) 7/IS/zZ Cma-c_6...ccpc C R-te- / 3i/2p, /(- - '*,,..,� Commonwealth o/Illaaeachassito Official Use erm Only • �� Pit No. t z (P(7-1 4 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 Code(M 527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL I O S/TION) Date: / �'/ vtt City or Town of: W. S 7 eukid Oa „ To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. kli Location(Street&Number) /(3 8 p_Q IA/e P ifr ,p3t. Owner or Tenant _Da Telephone No. 7 -l0 Owner's Address `'i Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. ciao Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters _ ) New Service i9 Amps /20/A. ) Volts Overhead Undgrd❑ No.of Meters _1 Number of Feeders and Ampacity //O 4/, Location and Nature of Proposed Electrical Work: c)44L/1 I I— ? zvI v1 Completion of thefollowingtable may be waived by the Itimector of Wires. Total U.) No.of Recessed Luminaires No.of Celt-Snip.(Paddle)Fans Tf Transformers KVA Se 1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA n Above In- 'No.of Emergency Lighting k No.of Luminaires Swimming Pool it=nd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detectiona Initiating Devices II-` No.of Ranges No.of Air Cond. / Tuna /" No.of Alerting Devices No.of Waste DisposersHeatT�p Number(Tons KW No.of Self-Contained ( Detection/Ale . ,' Devices No.o� Mashers Space/Area Heating KW Local 0 Man ❑ Other Connection W 1 o. Z era HeatingSec Appliances of or Equivalent > ` o. KW No.of No.of Data Wiring:a rs Signs Ballasts No.of Devices or iEquiraiwt W i o. massage Bathtubs No.of Motors Total HP Telecommunications bUr No,of Devices or �gEgq�uivalent _� Attach additional detail if desired or as required by the Inspector of Wires. (r Value of El 'cal Work: 0406; (When required by municipal policy.) m W..rti to. tart: 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 permi.� g office. CHECK ONE: INSURAN BOND ❑ OTHER 0 (Specify:) /, ,T 'I certify,under tihe n � rn of , the information on 1369.3.64)(9 . s application is true and co FIRM NAME: SIT� /i j' e .ter e%(Zi\C LIC.NO.:� Licensee: ± ( t signature l ` ` LIC.NO.: 3 y/3_3—G (If applicable,enter"exempt"in the line , Bus.TeL No.: c/ Address: r7 /—,�4_1i24, 7j ,21ii2`ieid /A4j� © ?7/7 Alt.TeL No.: 7'7 f1 y-eY4_5"--- *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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$