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HomeMy WebLinkAboutBLDE-22-003146 ,- Commonwealth of Official Use Only , Massachusetts Permit No. BLDE-22-003146 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:12/2/2021 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) 233 CRANBERRY LN Owner or Tenant Neil Thibodeau Telephone No. Owner's Address 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: Low voltage wiring for TV's&speakers. 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 Stens 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: 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. PERMIT FEE: $190.00 eau 44 (4 lo Commonwaa[h o/t•//aeaachiudatta Official Use Only �'�� Permit No. �tif,�• cc�� cc77 ��ii trui ^.;N• �UsPartnunt o�}iro Jorvicse 11/4 a 1<r, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/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: 0—a, — () a i 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) A _ G a.A a , r A. 0 _ A /A 0 c-),.Owner or Tenant NP t r'nt�' 11ltik_ tk. Telephone No. so,-ae, ,2<- Owner's Address �` this s permit In conjunction with a buildingpermit? Yes P�o ❑ (Check Appropriate Box) Purpose of Building Utility Authorization o. Existing Service d)Amps 1, 0 / f jQ Pits Overhead❑ Undgrd No.of Meters 1 ( New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: Li D/ .gr f©`— � `L h©�; cuAL, ,, ,..Teci6—er- e Completion of the following table may be waived by the Inspector of Wires. 11.: No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)FansNo.of Total o K Transformers VA '=;t No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ Ivo.of Emergency Lighting grnd. and. 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. ons! No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ �� Connection 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: fr No.otDevices or Equivalent � Uel ve 'Vit" 7/ It) Attach a natail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Wo �, /tie.° (When required by municipal policy.) Work to Start: spections 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 sins and penaltiesof erf ury,that the information on this application is true and complete. •,. k 4 FIRM NAME: k- ,-�N Q E le dr G LIC.NO.: Licensee: Zi �. �S� � j� SignatureIhe�!� / LIC.NO.: ��h ulA, C-' (If applicable,ever"exempt'in the license number li e.) Bus.Tel No.; Address: 'K 6-t 0 U` — .3-1.- / ,ir.- J 1.01-Cif,'rn '" fliC1 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Departm• .t of Public Safe "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 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$