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HomeMy WebLinkAboutBLDE-22-001851 Commonwealth of 1 Official Use Only E XVIIMassachusetts Permit No. BLDE-22-001851 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:10/1/2021 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) 11 WEDGEMERE RD Owner or Tenant ALBRECHT KELLY M T: •phone No. Owner's Address 11 WEDGEMERE RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No II (Che Purpose of BuildingUtility Authori ation No. ; Existing Service Amps Volts Overhead 0 Undg • 0 '6.o ' e4 erg` New Service Amps Volts Overhead 0 Undgr, 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire kitchen&living room. Replace panel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 9 No.of Ceil:Susp.(Paddle)Fans 2 No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators / KVA No.of Luminaires Swimming Pool Above 0 In- 0 No.of Emer4 y '- (1 grnd. grnd. Battery . .'t No.of Receptacle Outlets 20 No.of Oil Burners FIRE Z44" s No.of Switches 10 No.of Gas Burners No.of 1 •• 71r, ap Initiating Dev No.of Ranges 1 No.of Air Cond. Ton Total No.of Alerting Device Q No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Ot • 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:) //(_ _"'WA. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. 17 ."2.75--O© r FIRM NAME: Licensee: Robert Scala Signature LIC.NO.: 55987 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:24 Wagon Wheels Lane, Brewster Ma 02631 Alt.Tel.No.: 5085555555 *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: $75.00 C(Fili-ket_> iclzlzy k . c< , 1 (150(7_& RE ._EJ E �ry� t► o rtwea 4/rlaeeac/it„114 Official Use Onl 012021 Permit No.2_2— (ii• S tti j sit -comic*, rt"p __.__-- RTMENT Occupancy and Fee Checked - 4 o! -a • . PREVENTION REGULATIONS [Rev. 1/07] (leave blank) ei APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical (M ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE INFORMATION) Date: 'Z l City or Town of: la r vl,t0 v 11/1 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) W J eon e.y e Y�( CS Owner or Tenant Kell J Telephone No. 40 0 3 qJ i e 03 Ke �r ecl�it ,/ 7�' . Owner's Address I I. t?.,yt r.ere ry) t,•�76t.✓ o.t1i1 Yvi, OZ(o 7 3 co Is this permit in conjuxiftion`with o building permit? Yes No 0 (Check Appropriate Boz) Purpose of Building 25�Cr P..- Utility Authorization No. Existing Service j Amps i00 / a y0 Volts Overhead E Undgrd 0 No.of Meters .1 New Service Amps 100 / ). Volts Overhead® Undgrd❑ No.of Meters <1- _�L Number of Feeders and Ampacity 9/ai.'O S I 1z phase Lok)ars? Location and Nature of Proposed Electrical Work: Sec iriCQ ` (Janet c ho►nie l iii tci,e,t Liv I c oor o. Rew;z- Completion of thefollowinktable may be waived by the It:vector of itires. t No.of Recessed Luminah s CNo.of Celt-Stop.(Paddle)Fans a No.of Total � I TransformersaKVA No.of Luminaire Outlets g No..of Hot Tubs Generators KVA KA No.of Swimming pool Above ❑ In- ❑ No.of Emergency Lighting g led. grad. Battery Units No.of Receptacle Outlets c g No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches l 0 No.of Gas Burners Initiating Devices 11,1 No.of Ranges /,� No.of Air Cond. Toad, No.of Alerting Devices No.of Waste Heatrotals:l p Number,Tons.._.:KW 210.of No.of DishwashersSpace/Area Heating KW Local 0 CMirDetectioA a a 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devkes 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 TelecommunicationsNofDevices r Wiring:l No.of Devices or Equivalent OTHER: SI Attach additional detail if desired or its required by the Inspector of Wires. Estimated Value of Electrical Work: )10 90 (When required by municipal policy.) Work to Start q r).°11 a\ 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 fig BOND 0 OTHER 0 (Specify:) I cerdjy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MoUt'A Vet'tcOn Eye \tAr.f.7G ccs. CONTAkli LIC.NO.: JFK, Licensee: 33(JC wcivi\ ..1px\ ciao Signature . �6-4$ZRI J LIC.NO.: (If appllcabl enter"ex pt"in the license nu r line.) i� Bus.Tel.No.• v )73 Address: a'\ U hue,\ Lc VCS ik lP ©7►�3\ Alt.Tel.No.: *Per M.G.L.c. 147,e 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 m igna `;,•low,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Sigttxtrrr. _ ,.; Telephone No. (003 9q9 t37-q PERMIT FEE: