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HomeMy WebLinkAboutBLDE-21-007495 i or Commonwealth of Official Use Only `� C-. Massachusetts Permit No. BLDE-21-007495 ` �• ,; 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:6/24/2021 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) 2 WALNUT ST Owner or Tenant CLARK MELANIE Telephone No. Owner's Address 2 WALNUT ST,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 6007859 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 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 tp enwai ' b t Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Tra ers ii, A No.of Luminaire Outlets No.of Hot Tubs Ge o No.of Luminaires Swimming Pool Abovegrnd. ❑ In- ElNo.o :r'Um © grnd. BatteU il,7 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS o i eq/ /�� No.of Switches No.of Gas Burners No.of Detection and ( tJ 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 Equivalent No.of Water KW No.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: 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: SHERWOOD E LEWIS Licensee: Sherwood E Lewis Signature LIC.NO.: 11503 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 283,YARMOUTH PORT MA 026750283 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 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 /2V .,d c t' !P 1! E� Commoisi(erg o`Mossae ����Of��fici��al Use Onl? r g Permit No.�l�l '7`\ t t'1, tt5 ,. s �, �. �rparinrs -comical 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: 13744ZZ 2d 2 f City or Town of: 1 fIr.,,,nilt To the Inspector of Wires: By this application the undersigned gives notice ois or her intention to perform the electrical work described below. Location(Street&Number)I'}7 t e I ant C/w'�t'v InC4t .5f reC4'- YA/�'1tdiAif'�/ ' M 402 G7 S sOwner or Tenant Telepone No. 4�1 0 Owner's Address 2 w 4c I n tA 4- c f re.e f 'r,,,d4'e=r5- ,-yl4. G2G 7�- co Is this permit in conjunction with a building permit? Yes 0 No (Check A propriate Box) Purpose of Building Utility Authorization No. 00786 / Existing Service/0 O Amps /10 l[Z.O Volts Overhead i Undgrd 0 No.of Meters r_ New Service (OO Amps i 2O //2 Volts Overhead® Undgrd 0 No.of Meters 23 44 715 Number of Feeders and Ampacity S'j n I p AG5 . Q. Location and Nature of Proposed Electrical Work: A ' , It. • . Y. I •Z Seric;C 1,‘ 104. eeAf-er(tine 1 f an vi Completion of the follcnvingtable into,be waived by the Ins t'r o Wires. No.of TToottaa No.of Recessed Luminaires No.of Cel.-Snap.(Paddle)Fans Transformers ICVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No. 1JLighting vt No.of Luminaires Swimming Pool grad. ❑ fid, ❑ Batteryof Unitamergency No.of 011 Burners FIRE ALARMS INo.of Zones No.of Receptacle Outlets �o.of Detection and No.of Switches No.of Gas Burners Initiating Devices tal 11? No.of Ranges No.of Air Cond. Tu No.of Alerting Devices Heat Pump Number..Tons K1. W.. _., No.of Self-Contained No.of Waste Disposers Heat I Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Muni Other❑Connection * No.of Dryers Heating Appliances KW Security Systems' No.of Devices or Equivalent No.of WaterNo.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications W No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desire4 or as required by the Inspector of Wires. _ Estimated Value o Electrical Work: (When required by municipal policy.) Work to Start: 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: Unless waived by the owner,no permit for performance of electrical work may issue unless the licensee providesprooftion"coverage or its substantial equivalent. The of liability insurance including"comp undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE al BOND 0 OTHER 0 (Specify:) penalties nal ies of perjury,that the injbrmation on this application is true and complete. I ccrdfy,under the pains LIC.NO.: FIRM NAME: IC.NO.: I I S'o Licensee:�A a veD 0 r 1 Signature S 5 On Bus.Tel.No: tJ 4-2. v' i enter, 'esA t"in the li u(e( 5r line.) ) PIA, D-$ 3 7 Alt.TeL No.: Address: ,0147, �,,�f Uit work ro4iires Department of Public Safety"S"License: Lic.No. *Per M.G.L.c. 147,s.5761-,security 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)0 owner 0 owner's agent. Owner/AgentTelephone No. l PERMIT FEE:$ Signature