The URL can be used to link to this page

Home My WebLink AboutBLDE-21-007012 - �`� Commonwealth of Official Use Only t Massachusetts Permit No. BLDE-21-007012 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:6/3/2021 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 electncal work described below. Location(Street&Number) 10 CAMPION RD Owner or Tenant Stuart Saposnik Telephone No. Owner's Address 10 CAMPION RD,YARMOUTH PORT, MA 02675-1560 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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install lights in ceiling of farmers porch. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 5 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 0 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 Initiating 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 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: Licensee: Signature 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: 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 4 /24 W # i ..,,,A. Commonwealth 0/Maeeachu eit Official Use Onlly/� ,i 1' : '` y' .F 1 c� c7 Permit No. 6 t •-z, F 2spartmsni° iro Ssrvicse s fl.,-.‘1( ' .3 cy and Fee Checked • ,, i BOARD OF FIRE PREVENTION REGULATIONS [Rev. OccupI/0an7) (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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4,—Z - 21 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) /0 Cwt i' 'o r.7 q-O Owner or Tenant ��,,A.4,_ ,P.QGSAS X., Telephone No.9"13-113- i s Owner's Address 10 C.,p,t.,2 s o rV R,.., 1 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)e'L D'Zt'�''9 Zr Purpose of Building F�+.Z.nF�.S �� Utility Authorization No. Existing Service Zny Amps / Volts Overhead❑ Undgrd® No.of Meters k New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity E c ��,‘.�Nva- o Location and Nature of Proposed Electrical Work: cg.c s-...„4.4-s. 'Z�‘1, ,, , td Completion of the following table ml be waived by the In ector of Wires. No.of Recessed Laminate es �j No.of Cell.-Snap.(Paddle)Fans No.ofTotal "f Transformers KVA 'Zt No.of Luminaire Outlets No.of Hot Tubs CAGenerators KVA A No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. 0 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 i r Initiating Devices Tota No.of Ranges No.of Mr Cond. onsl No.of Alerting Devices Number No.of Waste Disposers Heat Pump (Tons KW No.of Self-Contained Tom:l I_ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Mel' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: 1.1 Op Attach additional detail ifdesired,or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: 4-5—21 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 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: Licensee: LIC.NO.: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Address: Bus.Tel.No.:__________ Alt. *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 signatu ., below,I hereby waive this requirement. I am the(check one i4 owner Owner/Agent w owner's a:ent. Signature Telephone NA—IS-11S-59 1 5 PERMIT FEE:$ '2 S—_ l'1 i i k 4& G h'-,41.,-t , co r.