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HomeMy WebLinkAboutBLDE-22-002709 Commonwealth of Official Use Only t Massachusetts Permit No. BLDE-22-002709 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:11/10/2021 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) 12 TOWN BROOK RD Owner or Tenant VARA CHRISTIAN D TR Telephone No. Owner's Address C/O KENMORE MANAGEMENT, 654 BEACON STREET SUITE#4, BOSTON, MA 02215-2099 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)1 _,�,t}/yei Purpose of Building Utility Authorization No. 6636837 1V�"n t1.1J ���/R, Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters i (�(661 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary 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- ElNo.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 Totals: Detection/Alerting 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 Eauivalent 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 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: Licensee: Israel Magagnin Signature LIC.NO.: 23065 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 Summit Avenue,Lynn MA 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 Q1L3t, c1 (47,1 "-' RECEIVED ,}OCT 292021 petmi49,0 `�\ ______ --------- mmonuwsalth o/Maeaachuoaffe Official Use Only '4M DEPARTMEN (,� 't;'+!K:•Xi �/-- ��'77 Permit No. .�'ai�s apartment o`.}ire.Sarvicse ,l-2., s Occupancy and Fee Checked `ti BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) N APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Codc(MEC ,527 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I C -7,irp -2 o' ?, 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) I 2_ '-(C(Xii1 i3Ya©K coo IR Owner or Tenant e-V ---rp ,--,-7qq 5 I Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes n No Sli (Check Appropriate Box) Purpose of Building Utility Authorization No.6 6 36 s 3 72 Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service I CC Amps j)t1/ Volts Overhead.' Undgrd ❑ No.of Meters ' i Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: tr Completion of thefo!lowin�table m be waived by the Inspector of Wires. vpp _, No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.o Total -11 0, Transformers KVA ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. 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. Tons No.of Alerting Devices 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❑ Municipalonnect io n ❑ Other C No.of Dryers Heating Appliances KW Securi No o Systems:* Devices or Equivalent No.of Water KW No.of No.of Data Wirin e Heaters Signs Ballasts No.of Dvices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: '1.� poi lY\ 3 P 1',„, C e . 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: /0 —2 cis_202 j In ections 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 Eg BOND 0 OTHER 0 (Specify:) I certify,under the',flips and penalties of erjury,that the information on this application is true and complete. FIRM NAME:1 " Clec hi j� LIC.NO.:2 3 ( O6 5 v.4 Licensee: • Signature 0 LIC.NO.: (If applicable,enter exemp ;he'e e umber line.) �" Bus.Tel.No.: 44/?@1 t/ K Address: f V l y .4 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work r1equires 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: $