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HomeMy WebLinkAboutBLDE-22-002818 Commonwealth of Official Use Only �.. Massachusetts Permit No. ,BLDE 22-002818 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:11/16/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to per orm the electrical work described below. Location(Street&Number) SON COURTLAND WAY iq Owner or Tenant MUIR MICHAEL TR ( Telephone No. Owner's Address J &S CAPE RLTY TRUST, P 0 BOX 62,WEST BOYLSTON, MA 01583 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. 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 1 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 ❑ Municipal ❑ 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 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: JOSEPH W SILVA Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 30 BOURNE HAY RD, SANDWICH MA 025632761 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 v P Pti\' QUJ(*lii.en /Sr p"'E //�� ti t,ommonweafth o/Ma�acI udettd Official Use Only ►= =1t Permit No. mie_ 2eparmen o reServce 14— Occupancy and Fee Checked _`, BOARD OF FIRE PREVENTION REGULATIONS [Rev. (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: /7— S- 2 f City or Town of: ` i-47nex-' /-i-- 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) a` 'I (7C,,-tJft-72,3,^io G v 4, G,ki , 1/I,2,1-7 w7Y- A Owner or Tenant )71(!/ice- ryi U i 2 Telephone No. Owner's Address , /17� E Is this permit in conjunction with a building permit? Yes U No ©—Check Appropriate Box) Purpose of Building Utility Authorization No. c Existing Service Amps / Volts Overhead 1- Undgrd❑ No.of Meters n n J New Service Amps / Volts Overhead I l Undgrd n No.of Meters N Number of Feeders and Ampacity `� Location and Nature of Proposed Electrical Work: % i L o.iJ ti0% IC.77'4,a-e..E,‘74-=✓7 S Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency-Lighting No.of Luminaires Swimming Pool grid. ❑ grnd. ❑ Battery Units .- No.of Receptacle Outlets No.of Oil BurnersFIRE ALARMS No.of Zones oNo.of Switches No.of Gas Burners No. In Detention and Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons posers Heat Pump Number Tons KW No.of Self-Contained No.of Waste Dis P Totals: ,Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ Connection Other El No.of Dryers Heating Appliances KW Security Systems. T No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 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: //- -Z/ 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 after_ __ CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) 6.9,41/yl�/lG� .�'4.1. I certibl,under the pains and penalties of peduzy,that the information on this application is true and complete. FIRM NAME: S/1..,\/A L i LIC.NO.:i4?/'`/7 Licensee: . '.si ht ti•! S U-.Jam" Signatur i LIC.NO.:£Z(c 1•7 (If applicable,enter "exempt"in the license munber line. �. Bus.TeL No.'s k•-`fZ 0``fie Address:3D .3 ocl2�t - 1 -"l � 3�,J7Mci /1'1.9- oz 5 i.S Alt.Tel.No.: G 3G 473l *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 my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ Signature _Telephone No.