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Home My WebLink AboutBLDE-22-000984 ____.. \k\.3( Commonwealth of Official Use Only :d? itIV Permit No. BLDE-22-000984 i�. Massachusetts x 4 ''` %,�` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked w JRev.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:8/20/2021 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 electrical work described below. Location(Street&Number) 154 CAPT SMALL RD Owner or Tenant Michael Medeiros Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: NATHAN A ASHE Licensee: Nathan A Ashe Signature LIC.NO.: 21136 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 166 Hunt Rd, Chelmsford MA 018243747 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 1.4 ' 1. 121 C.- C,ommonurealfh o`V70440C110.4811.1 Official Use Only P'=**-= Ct c c7 Permit No. en V 9 g. ,..4 "B�—' .2)epartmenl o/._tire�ervices =I j=? 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) 27 CMR 12p0 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT Date: QQQ 1� City or Town of: V n 0( To the Inspector of Wires: By this application the undersigned giles loticea or her intention to perform the electrical work des ribed below. Location(Street&Number) ‘ ( n S t 1 M Owner or Tenant i Chat.( � 'o1er I y O Telephone No. V Owner's Address CidtrA e. Ct/r— °tie _ Is this permit in conjunction with a building permit? Yes ❑ No �. (Check Appropriate Box) Purpose of Building at,k, t I ( Utility Authorization No. Existing Service 100 Amps 12C)/2S-tpoltsNJ Overhead ❑ Undgrd n No.of Meters I New Service I vv Amps 1 2.0/2,,LICilts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 10O �-rn p S Le Completion of the following table may be waived by Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf T 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 of No.of Switches No.of Gas Burners No. Initiatinnggon Dete and In Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g 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❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW SecNo o Systems:* Devices or Equivalent No.of Water Kam, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications quing No.H y g No.of Devices or Equivalent OTHER: Q '..N 1 CO Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:I l W ' (When required by municipal policy.) Work to Start: 1 f J 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 ❑ OTHER ❑ (Specify:) I certify,under th ains and nalties of perjury,that the in orm ' on this aeplication ue and complete. FIRM NAME: r -'t'1 ' u e TV U LIC.NO.: Licensee: ( Signature LIC.NO.: 1 i 3 ft (If applicabl enter"exempt"in the license number ling.)� Bus.Tel.No.: Address: tk S{Ot•via 1 bllSk —Malin ) Alt.Tel.No.: *Per M.G.L.c. 147,s.5 -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. PERMIT FEE:$ • • • s• • • • • • • • • • • i 1 ' I