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HomeMy WebLinkAboutBLDE-22-002081 €` Commonwealth 0of Official Use Only Massachusetts Permit No. BLDE-22-002081 BOARte' D 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:10/12/2021 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) 156 SWAN LAKE RD Owner or Tenant CIFELLI GEORGE W Telephone No. Owner's Address CIFELLI ANN, 156 SWAN LAKE RD,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 100 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: Rough,finish&underground. 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Ballasts Data Wiring: Heaters Siens 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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: $180.00 Kou04 !o/;�zi iv/t goK amu..d D✓rr/vr Ovrter's, I To A& 74 tL Ai via) -i t\tu 4 ONDIA,1 (— t 120C-k eI`A r11.9 J7,1 rte. -. Commonwealth of Massachusetts 2zJVila,le �Z©g e _. Permit No. T0'-7-0' -At Department of Fire Services 1Occupancy and Fee Checked �� �1 M, BOARD OF FIRE PREVENTION REGULATIONS IRev.9/0.51 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICA oWORK All work to be performed in accordance with the MassachusettsElectrical code^MEC),527 CMR 12�� � l (PLEASE PRINT IN INK OR TYPE ALL i.VFORMATION) Date: O` c!- ,) City or Town of: V,nyvi-vi-k 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) 15J Co, . G 4 4.-' V�n -t Anne. /1 t 1t1 Telephone Nol-K0 L- 2-- Owner or Tenant l� Owner's Address 45 ehlII eJ Yar t X7t Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building'Dwt(l It1 ) Utility Authorization No. �W Amps Iw / 1'tOVolts Overhead E Undgrd❑ No.of Meters ( Existing Service I New Service { Amps / Volts Overhead❑ UndgrdI No.of Meters Number of Feeders and Ampacity U r- Location and Nature of Proposed Electrical Work: R a,qh t i�'(�l�l' l t Completion of the following table may be waived by the InspectTotaor of Wit es. No.of 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 Swimming Pool Above In- `o.o mergency ig mg grnd. ❑ grnd. ❑ Batter Units No.of Oil Burners FIRE ALARMS No.of Zones No.of Receptacle Outlets etection ana ! `o.o No.of Switches No.of Gas Burners Initis Devices No.of Ranges No.of Air Cond. otal No.of Alerting DevicesTons Heat Pump I Number I Tons I KW No.of Self-Contained No.of Waste Disposers Totals: l Detection/Alerting Devices Municipal Other Space/Area Heating KW ;Local❑ Connection No.of Dishwashers p ecurity ystems: No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of WaterNo.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or E W uivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. a Estimated Value of Electrical Work: (When required by municipal policy.) Work to Starter . 5 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the ownercomp eltedtoperatiofor the nt'Ccolmance of vemge or t<scctrical work substantial equivalenty . The Thess the licensee provides proof of liability insurance includins� undersigned certifies that such coverage is in force,and has exhibited x ibite proof oof same to the permit issuing office. CHECK ONE: INSURANCE 71 BOND 0 informationapplication is true and complete. I certify,under the pains and penalties of that the on this te LIC.NO: FIRM NAME: �-ECT 1 ` 1' LIC.NO. �.Z -T.!s Gid �C�1E Signature /� .% . t• • , Licensee: i u4.r. Bus.Tel.No.: (If applicable,enter "exempt" in the license number linty IN �-I 1 , �,A`n •Z Alt.Tel.NO: liN''�' 2. Address: �•r• 10,0 O . � /V i l_►i'i *Securityer here: System Contractor License required for ie thathis work; ilf ice slee bvesle,e of/anvelicense the I abilitybnst ranee coveraogvnere rs anent. y OWNER'S INSURANCE WAIVER: I am awa owner 0 required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑PERMIT FEE: $ Owner/Agent Telephone No. Signature