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HomeMy WebLinkAboutBLDE-21-004678 robe,,,, Commonwealth of Official Use Only :rtli Massachusetts Permit No. BLDE-21-004678 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 ASE PRINT IN INK OR TYPE ALL INFORMATION) Date:2/18/2021 City or Town of: YARMOUTH To the Inspector of Wires: his application the undersigned gives notice of his or her intention to pertorm the electrical work described below. ation(Street&Number) 11 BUTTERCUP LN ner or Tenant GUARINO CHARLES P JRPie Telephon ner's Address HILL ELIZABETH,53 BRIDGE ST, NEWTON, MA 02458 O his permit in conjunction with a building permit? Yes 0 No 0 (Check p -pose of Building Utility Authorization No. fisting Service Amps Volts Overhead 0 Undgrd 0 No.of Mete w Service Amps Volts Overhead 0 Undgrd 0 No.of Meters mber of Feeders and Ampacity 4 cation and Nature of Proposed Electrical Work: Remodel wine cellar&stairway area. Completion of the following table may be waived by the Inspector of Wires. o.of Recessed Luminaires 15 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA o.of Luminaire Outlets 3 No.of Hot Tubs Generators KVA fo.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units lo.of Receptacle Outlets 20 No.of Oil Burners FIRE ALARMS No.of Zones 1o.of Switches 13 No.of Gas Burners No.of Detection and Initiating Devices lo.of Ranges No.of Air Cond. T Totans No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained 6 Vo.of Waste Disposers Totals: Detection/Alertine Devices Space/Area HeatingKW Local ❑ Municipal ❑ Other: No.of Dishwashers p Connection Appliances 1 KW 3 Security Systems:* No.of Dryers Heating PP No.of Devices or Equivalent No.of WaterNo.of No.of Data Wiring: K��' Signs Ballasts No.of Devices or Equivalent Heaters Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 age or its substantial equivalent.The undersigned certifies that such coverage is in force,and has exhibited proof of samethe permitissuing OTHER 0 (Specify:) CHECK ONE:INSURANCE 0 BOND 0 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Michael R Prevey LIC.NO.: 31458 FIRM NAME: Signature Bus.Tel.No.: Licensee: Michael R Prevey Alt.Tel.No.: (If applicable,enter"exempt"in the license number line.) Address:3 ALPINE CTR,SAGAMORE BCH MA 025622303 work requires Department of Public Safety"S"License:• *Per M.G.L.c. 147,s.57-61,Security aware that the License does not have tbrr ity l�orwrier's agentgc normally required by law.But WAIVER:I am ❑he ownliae OWNER'S INSURANCE uirement.I am the(check one) �g,00 signature below,I hereby waive this req PERMIT FEE $ Owner/Agent Telephone No. Signature 3f(c/211 l� T 0es�ay mullet . - ` _ BOARD DF FIRE PREVENTION REGULATIONS (Rev.7117] fig wink) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All ve&to be pe themed.in aceesdno=with he kbeesebasetts St feel Cara 0.03C),517 ChM 17-UD (PLS PlaNT1N.INg DE TPPPALL 124202,101170119 Dram .2-1.2- a City oro� Q rm a t 1'li To the trap r of}'fres: By appB�� gives notice anis at her=onto pe the eical wont e'e scnIci bolmm. Location(Street&Number) Ii &c III r-e.iy a 10,14..... Owner or Tenant C<htk-17 4' 1.4,1/nv Telephone Na. 'Owner's Andrea 52 ,(5r,'% ff. Ned-,710d . Is this permit m to ehosetihm with a baildino permit' Yes ® Na ❑ (Cberk.Apprapriats Rear) of Biandhig ' 4.P/dve•iia Heinz— _Milky Areascmction Na Sslsting Service Amps / Volts Dresimod.EJ Unapt 0 No.Dilaters New Service Amps 1 Valls Overhead 0 thulgrd 0 Na of Meters Number of Fe eedets aatAtapaaiy Lofmt and Nature of?ropaoad]deal.Woric 1I,,,i,, fid4iL S,dt ,4e ,, ea/,„(et�:d.... CDsple m retie. able man'be wand by rhe inspectrer trireme. Na.of 8esenaed.r mase s I5 No.of Ce�.Sasp.(Psuid a Fant of Trof KVA.totaHVA • 7!lo.of Tactains it Outlets Na of Eat Taps Generators KVA. Na of Lutra_iresAbove EaAa at iCmairy 1- g og 3 swhII g>weot crna. ❑ -era. ❑ 8aitary U , Nn.ofPeccpterle Dem 40 Na.of Oil tamers FIBID ALARMS No.dial= Na of Redick= /3 Na.of Goa Barman `Na Tirtifillittr = 49 • Na of Eanges No.of Air Coad. To* Na of Alm Deviea ' • Na of Waite Disposers Si p-Nuuber-Jona KW a of Som'„ iaed Tatters: D on/Alertiee'Depicts Na of Dishwashers Spease/Area Hag ICW 3 le irJ .Lanl 0 Goon 0 Dither Na of Dryers Hokin Appii uec eys gyq le No.of ices or meat Na of Weber KW 'No.of N m Ballads Dais Wi gimesNa of Davie=or ; . , Na Hydroma a Na of yrs Total B T Na of Devices or : • ,.• — OTHER: F.sEma�zd Vane i Wart G ©t� Attach addtilenel deuai!it desired,or at regeared by the of Wirat. (When repined by=nicipal policy.) World])Start a-10-al Inspections In be acquentadia=calm=with MEC Itnle 10,=lap=c:cospletirsn. INSURANCE COVERAGE: Unless waived by the owner,no pt Sar the pecrammrsz of electrieal wahtt tasty issue tales .the Bozo=provides proof of liability hour once ir,minding"conglletcd°po a ce c aveaage or ifs solestaottal equivalent The eked tethers&te ac>dh crone is inform,anal==Matted proof of same to the petent issuing acerace. • CHECK orlaoND 0 OTS. 0 (sperm) I corfify,ander flap:am and pawkier of perjerra,that the atformotioa an this oppficrareen it trio and complete FMNA: H/ame'/ Pre i'' 11e4:ftc 1 0t."J LIC.Nn: .3iq.5Y Luau: tight/ei .-c-vt6 Lac NO: W eat. . ,P ikiffreLinr4 Bus.TeL Na: 76r- a-7 4_.-5`�iF Address: ,) isc, C�r JO dolt to p�.tc 7 /7ui?. O."--/G,.� A.k.TeL Na.: *Pee M.GL.e.141,r 57-61,mscx requires Deparianit at-Public Safely"Si'License: Lic.Nn. . OWIMR'S IN6't7EANCE WAIVER: I axe aware that the Li=es=does not have the liability iesneeee cavatage=wily required.d.by law. By my signature below,I hereby waive this a quiresoc t I am the(ehea+ie one)0 owner 0 awaar's agent . Owner/Agent Signature Telephone Na. PE ACZT 14722: $