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HomeMy WebLinkAboutBLDE-22-007471 . Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-007471 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:6/29/2022 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. Location(Street&Number) 39 HOOVER RD Owner or Tenant June Knochin Telephone No. Owner's Address 39 HOOVER RD,WEST YARMOUTH, MA 02673 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: Wiring for new air handler. 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 No.of Detection and Ipitiatine Devices No.of Ranges No.of Air Cond. 1 Totalo 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 ❑ Municipal ❑ 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 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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 Deg Pk.h:11, t 6V Cp.,4-t4tt__ s ouLM Q I RECEIVED g " JUN 2 8 20 r, , .a&•/Iljamacluseeilo Official Use only g `t ! P c7y Permit No. 2 7'1 71 " - d _i ILDINGDtPARTv ',T e irsSi'vke Occupancy and Fee Checked f 1' - - - - - „--- 'EVENTION 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(MEC),527 CMR 12.00 d (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: (o-f).%- .a ,L) City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ofhis or her intention to perform the electrical work described below. e Location(Street&Number) 3 1 goov e c goal, f!s Owner or Tenant one Knee 01 it\ Telephone No. 781 M ba$8 Owner's Address 3i. )-100.1 tC `i to Is thispermit in conjunction with a !1-�j a building permit? Yes ❑ No [� (Check Appropriate Box) Purpose of Building DO CI\t Ai Utility Authorization No. Existing Service Amps J/ Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters ` Number of Feeders and Ampadty 1 !� Location and Nature of Proposed Electrical Work: (�l6 e. n 2.1,E iv L+ ei c -No.(-,c), le.r Completion of thefollowingtable may be waived by the Inspector of Wires. No.of Recessed Luminah es No.of CelL-SSup.(Paddle)Fans No..oof Total 1.1iKVA .�. Tartaformera KVA n No.of Luminaire Outlets No.of Hot Tubs GeneratorsKVA No.of Lamdnairea g�� p� Above In- No.of Emergency Lighting g Dud. ❑ grad. ❑ 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 4 Initiating Devices t LI No.of Ranges No.of Air Cond. Total No.of Alerting Devices ons No.of Waste Disposers Totals: Pump Number Tons KW No.of Reif-Contained Totals: -'~' Detectlon/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Muniidp 0 Other Ct►nnection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.ofData Wiring: Heaters KW Signs No.of ► a� ,•• or Equivalent No.Hydromaaaage Bathtubs No.of Motors Total HP Telecommunica, , , 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: J 5 00 (When required by municipal policy.) Work to Start: (p,). 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 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 pe perjury,that die information on this application is true and complete. FIRM NAME: jcS�Oc,. lna�C. r le.c.Tck C�n.c� —�• �� ` T LIC.NO.: Licensee: J a51�}� 1)1.,,30't.. Signature _i , LIC.NO.: 531140-Rj (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7Z'1`f 14 ©ltB3 Address: Mt.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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$