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HomeMy WebLinkAboutBLDE-21-003889 \ /./ of Official Use Only fi.* Massachusetts Permit No. BLDE-21-003889 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:1/14/2021 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) 446 ROUTE 6A O Owner or Tenant COX JOSEF PAUL Telephone No �� Owner's Address ``GCXD MELISSA 446 ROUTE 6A,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap: T i4 ConresonweatIL o`faedachueetts Official Use Only }' -: �� 2sparttn.nt o f tiny�irvr'cse Permit No. C�C�1 `'.: Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. i/07i . ] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK cAll work to be performed in accordance with the Massachusetts Electrical Code EC) 527 CMR 12.00 0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / 13 /7. J6 • City or Town of: total.il.tl�I To the I ect r of Wires: --- By this application the undersigngives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6144 f(o oufe_ 6 4 Owner or Tenant 1'4J i ycr (0i. Telephone No. Owner's Address 071 -t Is this permit in conjunction with a building permit? Yes 041 No ❑ (Check Appropriate Box) 1 I Purpose of Buildingv�t th tc .t•-- Utility Authorization No. I Existing Service c'O Amps R© / 24 b Volts Overhead® Undgrd❑ No.of Meters 1 LI, New Service 2.00 Amps 11.0 /Tho Volts Overhead® Undgrd 0 No.of Meters I Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: rtv cU ) 5�i a V 1? q,rc+i a e bcash f0 0 ". rc . c.0 Gvvl fJ_.w IcuiNAtri room v-1 Completion of the followin.glapk may be waived by the Inspector of Wires. 4i No.of Recessed Luminaires ii, No.of Cell. (Paddle)Fans No.of Total 'cuspTransformers KVA '`^ No.of Luminaire Outlets No.of Hot Tubs Generators KVA -4 Above In- No.of>vmergency Lighting <: No.of Luminaires 7 Swimming Pool Ern& ❑ Unca. ❑ Battery Units No.of Receptacle Outlets 21) No.of 011 Burners FIRE ALARMS No.of Zones d No.of Switches 1 Z. No.of Gas Burners No.Ini�ating Devices No.of Ranges No.of Air Cond. Tonsi No.of Alerting Devices No.of Waste Dbposers Heat Pump Number Tons KW �itals: D ofrpliA ces No.of Dishwashers I Space/Area Heating KW Local 0 Conn 0 Other No.of Dryers i Heating Appliances ' security Systems:* No.of 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 Rung No.of Devices or Equivalent `1 OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value f El trical Work: 1'i'OO (When required by municipal policy.) Work to Start: i 11) ZI Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 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 sucverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND [3OTHER 0 (Specify:) I certify,under thtjains and pe ides of perjury,that the information on this application is true and complete. FIRM NAME: 1 OL 1 .\€J l'i cc.1 C v��r c ci'%t S T.',,.c.. LIC.NO.: 2-0ci /5-11- /......„4„..../Licensee: �e, e;ti Le, ,n SignatureLIC.NO.: afa plicab e,enter'ez in tire t number line.) Bus.Tei.No.:-715I N3 C,�O 17 Address: -502i v.00kv. 1 Sr line.)__ i"% OZ'S b0 Alt.TeL No.: *Per M.G.L.c. 147,s.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 my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent ( PERMIT FEE:$ Signature Telephone No.