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HomeMy WebLinkAboutBLDE-22-005801 Commonwealth of Official Use Only /ilk- I Massachusetts Permit No. BLDE-22-005801 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:4/11/2022 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) 68 LILY POND DR Owner or Tenant Donna Goggin Telephone No. Owner's Address 68 LILY POND DR,SOUTH YARMOUTH, MA 02664 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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring of Automatic Generator with Auto transfer switch 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 1 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 Initiating Devices No.of Ranges No.of Air Cond. Total 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 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 Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: ALEXANDER LATIMER Licensee: ALEXANDER LATIMER Signature LIC.NO.: 54173 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:64 ROUND COVE RD, HARWICH MA 02645 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: $75.00 v Comnwnweal o`,aseac,udsits Official Use Only / / '1/4pa ii ;'t �sparEimnf o�.}rnr�srriitR! Permit No. £ . 4722"' 6- ' 7 S-Q/ t44‘� Occupancy and Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK CJ All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 N (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /--I -10-- 020J-c St or Town of: CLCrirl Oct-� 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) �f Lift// wv Pe )c;V e V Owner or Tenant Dph A a 6,19bc•A Telephone No. c),„... Owner's Address ✓) i Is this permit in conjunction with a building permit? Yes 0 No Ea. (Check Appropriate Box) 0Purpose of Building Utility Authorization No. (a Existing Service Amps / Volts Overhead El Undgrd 0 No.of Meters 6 X 1 New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters CO Number of Feeders and Ampacity a Location and Nature of Pro Electrical Work: (A i C`,rlo 0c a.,4(5 m ci,-k t G_ S t G,„d 1`),, t c eAne_'c.4-nc' i W1n©[e Vtor,se Airc. t Completion of thefollowing table m be waived by the 1�pector of Wires. otal l No.of Recessed Luminaires No.of Cell.-Susp.(Paddle) Traann sformers KVA Fans Trf _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of)emergency Lighting grad. out Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners -No.of Detection and Initiating Devices No.of Ranges No.of Mr Cowl. Toonas No.of Alerting Devices Na of Waste Disposers Heat Pump Number Tons KW "No.of Self-Contained Totals: ' — Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Connection 0 Other No.of Dryers Hefting Appliances KW Security S .* No.of Devices or Equivalent No.of Water No.of No.of Data Heaters "' Signs Ballasts No ofDevicesor Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: C24000C.D (When required by municipal policy.) Work to Start: if-( -gado? Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no perunit 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 {l BOND 0 OTHER 0 (Specify:) I certify,under dee Rains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: /il>- cc,( ;nn.ec LIC.Na: 541 t 7 3-,a Licensee: /gees Lc.4-vvteC Signature /�.,,,,_. IC.NO.: (If applicable,enter"exem t"in the license number line.) i Bus.Tel.No.: 77 H-07 i o?-S,3 qtEr- Address: .F ivIccy pc_fji. Ln. t-ffo,t-c,, c,k /L1/ O c7 61S Alt.TeL No.: *Per M.G.L.c. 147,' 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. PERMIT FEE:$