Loading...
HomeMy WebLinkAboutBLDE-22-005638 Commonwealth of Official Use Only Only ifi-1ti NMassachusetts Permit No. BLDE-22-005638 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:4/4/2022 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) 1314 ROUTE 28 Owner or Tenant PATEL MOHANVHAI TRS Telephone No. Owner's Address JALARAM VANI REALTY TRUST, 1314 ROUTE 28,SOUTH YARMOUTH, MA 02664 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 receptacle, install new receptacle, bat fan&Arc fault C/B 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 No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices 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 ❑ Other: 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Brian S Mcculloch Licensee: Brian S Mcculloch Signature LIC.NO.: 10089 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: • Address:7 UPLAND RD, BROCKTON MA 02301 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: $ 0.00 06 uhrs ezi 467//22-e6 e`--c c- V(ILl 22-- ee 6:)/VO 02$(ac=-o eol)-4 COX, ha'Y' —r( caNr / z12..) ©At,4a- MON LL Fes' 4((51--n-01-- RE.:CE I VED MAR 312022` _ _ CommonwaaGth col�/aeeachaeaita Official— Use Or}l B U I L D I N G DEP"°iv" =1,..=" / c� c� t1�Cmc—'SS CO C'� ey - -- ='_-a: r: .Usloari~nunl?o` tiro�arvresd Permit No. }'i l. , 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: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned,gives notice of h's or her intention to perform the electrical work described below. Location(Street&Number) 1 / A -r D Owner or Tenant / 4 kiA 4 4550 r A/c l Telephone No.7?If-.45'1_U Lf 57 Owner's Address I Is this permit in conjunction with a building permit? Yes, No 0 (Check Appropriate Box) , Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity 1Loodon � and N re of Propos Electtrical_Work: /.r Grp Completion of the_jollowingtable mTI be waived by the Inspector of Wires. t!b No.of Recessed Luminaires No.of Cell:Sas No.of 1 otal �� p.(Paddle)Fans Transformers KVA 1::.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA Wit,. No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS )No.of Zones No.of Switches No.of Gas Burners -No.of Detection and 11' No.of Ran es Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: '....__.._....__ j I Detection/Alertingpevices No.of Dishwashers Space/Area HeatingKWMunicipal Local 0 Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; No.of Devices or Equivalent OTHER: S c Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value o Elec cal Work: d 0 G� (When required by municipal policy.) Work to Start: 3 a 5/ ,a Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 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 N LIC.NO.: Licensee: /tan /4e 4 610 di. Signature /77-pt Ft"---1-' LIC.NO.:t Cd '5•Q (If applicable,enter"exem t"in the license umber line.) / Bus.Tel.No.•�b� G$5-r13Ct 6, Address: 2-G SPpr'tti e-- Gv,>yl4,e ev'Ta✓f1 C? g .No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Pub is Safety"S"License: Alt.Lic.TNo. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. ( PERMIT FEE:$ ._1L(_( -77., ems t03, Co (o s; (off (07 (08 10? 212e2- - : � 2c0(41 zo 20�, 22Lf, Z2S; 271227, 228r 22qi 23o/ 23t 4 Z3 2 , (o €i -ro j ri4- c Py'e VLLs F-Pet(i-i-s Nor (Ns r'° 3,) C'P42.4l Ai, auk a-lca k ('tet. 7 Cc. Nfrs S6/82A-C) az-- Mi ( ._pfls-)l � c— scuts PP R-t-- cit r� LcQtr-Ss or.) a Ad c 0-0rJ -t ! 1 ftAppi (6(tepr Z3( Zo5)