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HomeMy WebLinkAboutBLDE-22-005794 Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-22-005794 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:4/11/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to peiform the electrical work described below. Location(Street&Number) 51 SOUTH SHORE DR Owner or Tenant KAROL DAWN Telephone No. Owner's Address 424 ADAMS ST#202, MILTON, MA 02186 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: Replace exterior service&refeed panel. 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. 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 ❑ 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 Signs No.of Devices or Eauivalent 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: Licensee: Daniel Garner Signature LIC.NO.: 56683 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:63 Mapleton Street,Apartment 2,Brighton MA 56683 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. I PERMIT FEE: $50.00 elie. 4(f.74.0.4 ' "I`lk RECEIVED APR 1 aw Commonwealth oiaeaachaaafle Qff ficial Use Only L� - .,.',: -I/ �CJslvartn.nf �7 Permit No.�i 7 (� 1 BUILDING D E"• e o`.}irs Serviced ' '�'.-4' BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked By [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ME ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: C( II a a City or Town of: YARMOUTH To the I pe tor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) S 1 J 0J Al., 5 kcel r1 v`2, Owner or Tenant \0_,v,n L -0[ Telephone No. 6("7- 5'13 90i)- Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 1:21/ (Check Appropriate Box) Purpose of Building Re,$Lac,t, r)ck".,'a. 5-e_IVr'LL Utility Authorization No. Existing Service 1 03 Amps ()..c) / '. 0Volts Overhead Er Undgrd❑ No.of Meters l New Service J o Amps ('kg/a KQVolts Overhead[g' Undgrd ❑ No.of Meters I Number of Feeders and Ampacity `1 ((9r p 4 S i Location and Nature of Proposed Electrical Work: 004.-s i - (Z8e(tl.s_t_ 1^1ct...( 4 .f..c Viut \ACompletion of thefollowingtable may be waived by the Invector of Wires. i.! No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of- Total "j Transformers KVA �t No.of Luminaire Outlets No.of Hot Tubs Generators KVA ANo.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lightinggrnd. grnd. ❑ Battery Units ti No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS iNo.of Zones No.of Switches No.of Gas Burners filo.of Detection and- _ I Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW 'No.of Self-Contained Totals: ......-_.._.._ 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW "cal 0 Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.ofNo.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices o Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunication Wiring: OTHER: No.of Devices or Equivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value o Electrical Work: 31 l 6©p (When required by municipal policy.) Work to Start:-1 ( '_ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabili insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such co rage 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 Info , adon on this application is true and complete. FIRM N E: .a:..sLo1faak `..— "AM ., i 4..Lkr I c. Licensee: . '' LIC.NO.: `• oS ► Signature �� (If applicable,enter"exe pt"in the licenn�umber ince.) / LIC.NO.: `6 g — Address: '(e MA a ( Bus.Tel.No.:6o 3�3 �� *Per M.G.L.c. 147,s.57-61,security work 'quires Department of Public Safety"S"License: Alt.Lic., Tel.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 Owner/Agent owner • owner's a:ent. Signature Telephone No. PERMIT FEE:$ ,�b.00 co*cf