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HomeMy WebLinkAboutBLDE-22-000243 Oki Commonwealth of Official Use Only E0Massachusetts Permit No. BLDE-22-000243 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:7/14/2021 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 lectrical work desc . d be w. Location(Street&Number) 233 CRANBERRY LN N-� i I i1 �D Owner or Tenant Telephone No. Owner's Address .'..;;...1.3._ _ - - . ' t ,, -11,-;:"'__ .._,,L.- - --: .u•''':-:...._ 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: New addition. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 20 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 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 35 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 30 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 1 Heating Appliances Key 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:) 77 q--36,e -3 e rZ7' e 2- I certify,under the pains and penalties of perjury,that the information on this application is true and complete. (O -1 7 FIRM NAME: Licensee: Joshua Stone Signature LIC.NO.: 56574 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$75.00 I Qc.,66„ 10477.( ig . * RECEIVED � yfor �� V JUL 14 2021 . 14 BUILDING DEPA`' 'cLi a'Ils o/ aedachueatia Official Use Only '" . . r, — - e/ n Permit No.022-—di43 3 _.,1111.— r: spar of o f}u s Jsrvicsd ` .1 4 Occupancy and Fee Checked '''` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) y (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 I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 /1- - a oR 114N1City 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) Off ; C r e I,.e`r, y ct y9 .� �©�..1 y. 111 ^ Owner or Tenant /C 1 I 7'` 4 t� c �f Telephone No. - I I/ \ QJI t'( P o Q o2C'� Owners Address coS ��, Is this permit in conjunction with a buil ng permit? Yes L(� No El (Check Appropriate Box) © Purpose of Building It)e tJ ✓1't /i rp l ��t I ✓V Utility Authorization No. ..--+_. Existing ServiceO Amps QO/ olts Overhead Er..--Undgrd❑ No.of Meters VJ New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters ------fr Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: VI Completion of the followingtable nw be waived by the Inaoector of Wires. NA tit ei No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of Total Transformers KVA ::\ No.of Luminaire Outlets No.of Hot Tubs Generators KVA r� ' No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. ❑ Battery Units ` No.of Receptacle Outlets 35-- No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners -No.of Detection and 1 k r Initiating Devices Tota No.of Ranges No.of Mr Cond. ons! No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1KW No.of Self-Contained Totals:I "� Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal - Connection ❑ Other No.of Dryers ` Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: F000 (When required by municipal policy.) Work to Start: 7-' -a&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,f_o..r,�ce nd has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND CT OTHER 0 (Specify:) I certify,under the ,ains aridpen'!ties o rj ry, � pp ,� � fpe u that the Infor anon on this application is true and complete. FIRM NAME: {3 ♦ S ( i 3 d. A Licensee: ti 0. a E. LIC.NO.: t�/li�-, Signature _, • Of applicable er"exempt"in the license umber 1'ne.) t a�� LIC.NO.: Address: 4 ' s " r — _ of 'C..4 /,/ /� Bus.Tel.No.• �,s Alt.Tel.No.: ca Go Y "Per M.G.L.c. s.57-61,security work quires Department •f 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 Owner/Agent owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$