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HomeMy WebLinkAboutBLDE-22-001277 (,i of ,, i/\\ Commonwealth of Official Use Only '`. Massachusetts Permit No. BLDE-22-001277 • 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:9/6/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to p the electrical work ed below. Location(Street&Number) 67 SULLIVAN RD (, k.1C U A'A Owner or Tenant RT:: Telephone No. Owner's Address STErL940104141aght 67 SULLIVAN ROAD,WEST YARMOUTH, MA 02673 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: Relocate 4 switches,1 receptacle,&2 lights. 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 Ligh * ggrnd. grnd. Battery Units �j No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALA' . `; • t f No,of Switches 4 No.of Gas Burners No.of Detection . • 40 Initiating Devices C No.of Ranges No.of Air Cond. Ton Total No.of Alerting Devices No.of Waste Dis posers Heat Pump Number Tons1 KW No.of Self-Contained O P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local 0 Municipal E,P Connection No.of Dryers Heating Appliances KW Security Systems:* O 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: George B Vicente Licensee: George B Vicente Signature LIC.NO.: 36739 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 DUSTIN ST, SAUGUS MA 019061804 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 . 0 41 1/7/2.( 1 - K(,4 ( /((2 (.:2,0 `IN) • C.matonwesig olrt��llamac Official Use Only .UspaiGnerrt 45,..Services No. Z—C7 77 BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/0 and Fee Checked (leavo blank) ti APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 4 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 l'% (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �3 „7/ City or Town of: 1 L/ r >, iii To the Inspect r of Wires: aa' By this application the undersigned gi notice of his or her intention to perform the electrical work described below. Location(Street&Number) 4 7 5Lt It idA let Kms( • Owner or Tenant vi if(77T (u i,t ci n i Telephone No.!at: 1'5'6'.Wag' Owner's Address S'G/role_ . Is this permit in conjunction with aipuildbc permit? Yes ❑ No a. (Check Appropriate Box) Purpose of Building R.e. S;g-ifilnilivszc Utility Authorization No. Existing Service ,20 p Amps /2) /fie,/e Volts Overhead R' Undgrd❑ No.of Meters j New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters '-*'. Number of Feeders and Ampaclty V. Location and Nature of Proposed Electrical Work:7 ,7, e2i7; Al 5 L4it-re .5 I tr ,p 7� '.. o.; ?qW 7 1 t 741 I 54er/el/es - Nn Completion of thefollowin cable may be waived by the Inspector of Wires. Total LNo.of Recessed LTransformers KVA cl No.of Luminaire Outlets No.of Hot Tubs Generators KVA a AboveIn- Ivo.of Emergency Lighting 4' No.of Luminaires 3 Swhamhig Pool and, ❑ gr'nd. ❑ Battery Units No.of Receptacle Outlets / No.of OH Burners FIRE ALARMS No.of Zones nd No.of Switches e-f No.of Gas Burners No.of Devices 1 lJ No.of Ranges No.of Air Coad. Total No.of Alerting Devices Heat Pump Number Tens_ __KW_. No.of Self-Contained No.of Waste Dhtiposers Totals: —"I Deteetion/AlertIng`Devices No.of Dishwashers Space/Area Heating KW Local 0 u icipai 0 Other No.of Dryers Heating Appliances Kw Security * No.of Devices or Equivalent No.of Water , N .of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring No.of Devices or Equivalent OTHER: t„n Attach additional detail if desired oras required by the Inspector of Wires. Estimated Value of Electrical Work: V?2P-t—r----- (When required by municipal policy.) Work to Start f/� //2% Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C(O ;RAGE: 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 2-* BOND 0 OTHER 0 (Specify:) I certib,under thepins and penalties of perjury,that the inforptatlon on this application is true and complete. FIRM NAME: C-"ei,,'7-'e' I./. .....,..1.47&7_ el c°/- r' LIC.NO.: ✓ �f Licensee: , off . r . .' S;.,, _,,-i,.., „ r� ire, "MP LIC.NO.: . ' t✓ (If applicable, ' ,,t”in the llcgne number line.) , Bus.Tel.No.• ' - ` fr Y-" Address: J© 0 Lr yr?4,1 �'r']c 1 1-49/-9 S 77711 r col f9f9, Alt.TeL No AimaTdr 6/7 *Per M.G.L.c. 147,s.57-61,security work requires Department of PulRic 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:$ ,v. -- - --_ ---------- ----_Ri- t: 2113705451: 825802834511' 0218