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HomeMy WebLinkAboutBLDE-22-006050 Commonwealth of Official Use Only is A_ Massachusetts Permit No. BLDE-22-006050 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:4/21/2022 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) 32 SHORE RD Owner or Tenant Michael McChesney Telephone No. Owner's Address 32 SHORE RD,WEST YARMOUTH, MA 02673 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: Septic pump&alarm 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 ❑ n- ❑ 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 1 Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* Ny.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 1 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: PAYZANT ELECTRICAL CONTRACTORS Licensee: Kevin Mott Signature LIC.NO.: 22677 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 118 Long Pond, South Yarmouth MA 02664 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 (po w '974- 9zff, 4r E-GtAfo d5/c � �✓ IN ( on ILL i ) I (i, RECEIVED -r-/h S G(-VLr'i'Ce- pp 20 V .. "1'.:'t''... ,iNGUE FA i G Commonweah of Maeaaclueife Official Use Only Permit No. €11 lDOUsvartmsnf oI,}irs Serviced trte. p By '' 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ! — 2 Q _2 afze 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) 5 a , rE R b Owner or Tenant rn i v1= plc(i-t h )Ey Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: ' --ç .- "TT:30‘.3 I N c4 , kt1 fv Completion of thefollowingtable may be waived by the Invector of Wires. �! No.of Recessed Luminaires No.of Cell.-Susp. No.of Total n! p (Paddle)Fans Transformers KVA �=,1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA 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 INo.of Zones No.of Switches No.of Gas Burners ''No.of Detection and 1 Tonsal Initiating Devices No.of Ranges No.of Air Cond. ToNo.of Alerting Devices No.of Waste Disposers Heat Pump Imb Nuer[Tons {KW No.of Self-Contained Totals: 1. Detection/Alertinl�Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' 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 Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: t7.71�ZZ (When required by municipal policy.) Work to Start: q-Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no pennit 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: INSU' i. CE 0 BOND 0 OTHER 0 (Specify:) I certify,under the p ns and penaltio pm* ,that the information on this application is true and complete. FIRM NAM : !�'� A AU%/ n . ' = •-I 6 /L LIC.N0.• �i7 LZ(Q77 Licensee: t _l C Jl (���— Signature (If applicable,enter"exempt"in the license number line.) �`Z LIC.NO.: LAC- ZZ� 7� Address: Bus.Tel.No.• O „y36_7 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: AIL 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 a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$