HomeMy WebLinkAboutBLDE-22-002196 Commonwealth of Official Use Only
•' Permit No. BLDE-22-002196
Massachusetts
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:10/18/2021
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) 52 NAUHAUGHT RD
Owner or Tenant Christine Danielson Telephone No.
Owner's Address
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: 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- o No.of Emergency Lighting
grad. grad. 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 0 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
((f 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
11/(cti2i
Commonwealth..o/Mamaciutieth Official Use Only
•a-� '{
Permit No.'g _-
g ==Ym a UePartment ofcire�ervicee
_ _ 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: 1 d —/-_ z/
p_x.,
City or Town of: /'2, 7' To the Inspector of Wires:
By this application the undersignses notice of his or her intention to perform the electrical work described below.
s Location(Street&Number) .. JU0(.1/-/Jl-U )_h j R c) s. vAR/"1
8 Owner or Tenant G// S 77'Jt 1 A//.r= ri Telephone No.
Owner's Address _S✓},"-7g.--
Is this permit in conjunction with a building permit? Yes U No (Check Appropriate Box)
CI
Purpose of Building Utility Authorization No.
qExisting Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
In �--t �--t
J New Service Amps / Volts Overhead t l Undgrd ri No.of Meters
N Number of Feeders and Ampacity
I > �97/e -f 1'?( _<,5c.e:
Location�and Nature of Proposed Electrical Work: ���� lG�� Y Sc✓T�
--_ 4— .47G.�7 �/15 r--i.1�-.�r4-Cjef—
Completion of the followin•table may be waived by the Inspector of Wires.
q 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 grad. ❑ grnd. ❑ Batte Units
No.of Receptacle Outlets No.of Oil Burners ;FIRE ALARMS No.of Zones j
No.of Gas Burners No.of Detection and
No.of SwitchesInitiating Devices
No.of Air Cond. Total 1 No.of Alerting Devices
No.of Ranges Tons
Heat Pump Number Tons KW I No.of Self-Contained
No.of Waste Disposers Totals:- { i Detectiou/Alerting Devices 1
Municipal
No.of Dishwashers Space/Area Heating KW ;Local❑ Connection El Oil1Qr
Heating Appliances KW Security Systems:*
No.of DryersNo.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
Telecommunications Wiring
No.HydromassageBathtubs 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: / --( ,
c --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 office.
CHECK ONE: INSURANCE (BOND ❑ OTHER El (Specify:) t O////yl��C . J.( >gl/9"r�
I certify,under the pains and penalties of perjury,,that the information on this application is true and complete.
FIRM NAME: $/. j . F 1 -c (-rfad c-- LIC.NO.:�?/`/7
Licensee: bSs(h v-i s ie-Ji— Signatur LIC.NO.•.Z%G i7
(If applicable, enter "exempt"in the license number line.)._ Bus.TeL No.:- .R.-`KZ-g-`9�'
Address:c10 ,00t1 �- N4-`7 .a-J9r✓rGt in* oZ.C4-3 Alt.Tel.No.:6-0 3C,-`x'-/3/1
*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 El owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $