Loading...
HomeMy WebLinkAboutBLDE-22-000247 Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-22-000247 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:7/15/2021 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) 82 TAFT RD Owner or Tenant Stephen Feeley Telephone No. Owner's Address 82 TAFT 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 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 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 1 ► Z No.of Switches No.of Gas Burners No.of Detecti, tl —J Initiating D 'mac Z"`r No.of Ranges No.of Air Cond. Total No.of Ale r e i Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contac Totals: Detection/Alerting • ONo.of Dishwashers Space/Area Heating KW Local ❑ Municipal A:9 r: 4P Connection v No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent O No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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 perjuty,that the information on this application is true and complete. FIRM NAME: Lloyd R Smith Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST, MELROSE MA 021764010 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 IL, I �al• 7�� Official USC Only i, : �! 2Ct j Permit { ! Vg----1 7 i 2eparitnerd ol c --_ 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 CM,12.00 (PLEASE PRINT IN INK OR TYP ALL INFO Date: 1 - City or Town of: I To the Inspector of Wires: By this application the undersigned es notice of his or her intention to perform • electrical work described below. Location(Street&Number) • y --- '. Owner or Tenant en f c-- .i Telephone No. ' 2(,)1 i Owner's Address - A 4 Is this permit in conjunction with a building permit? Yes ❑ No ix (Check Appropriate Box) Purpose of Building / ;t ,. l I� X�1 A Utility Authorization No. Existing Service (_L>Amps I /"4...- -1. LY Overha�- Undgrd El. No.of Meters I New Service 2 Amps RC, /24Gooks Overhead•/ _ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 7 _r ' S(AA Completion of the following table may be ivalved 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 No.of Luminaires Swimmingp� Above ❑ In- ❑ No.of Emergency Lighting grad. grad Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Dever No.of Ranges No.of Air Conti To No.of Alerting Devices No.of Waste Disposers Heat Totals: Number Toes KW_ No. S n/AJI arced No.of Dishwashers Space/Area Heating KW Local 0 Mu ❑ Other ♦ Systems: No.of Dryers nesting KW No.yof Devices or Equivalent No.of Water , No.of No.of Data Wiring Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wq�u g Na of Devices or Egarvaleat OTHER: `; Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: S L. (When required by municipal policy.) Work to Start: (\-- MO• 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 suchis in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of ,thatthe information on application is true and complete. FIRM NAME:\I\ t- sot I� k 6 LIC.NO.: Licensee:Uc�61 7t.- c Yl t-C"�, -,.. _ - -. t.: I �C� S r) (Ifapplicable.enter"exempt"in the license number line.) , Bus.Tel.N - 1- Address: �`tV Mk) Stir•©(f c h bIM rS7:- AIL Tel.No.: y I 1_ C ? , *Per M.G.L.c. 147,s. 7-61,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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ a