HomeMy WebLinkAboutBLDE-21-001658 DV Commonwealth of
Official Use Only
bll Massachusetts PennitNo. BLDE-21-001658
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:10/1/2020
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) 51 BRADFORD RD
Owner or Tenant MILLS JEANNETTE AMATO Telephone No.
Owner's Address MILLS GARY J,20 MONADNOCK RD,ARLINGTON, MA 02174-8001
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. 2414611
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: Upgrade service,wiring addition, &remodel. /\ 7 '
Completion of the follow' •.le m ,.L�, , tAiepector of Wires.
No.of Recessed Luminaires 25 No.of Ceil.-Susp.(Paddle)Fans 4 No. /// Total
Tra
No.of Luminaire Outlets No.of Hot Tubs Generators pk)
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Li
grnd. grnd. Battery Units
No.of Receptacle Outlets 50 No.of Oil Burners FIRE ALARMS No.of Zone 0
No.of Switches 24 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. 1 Total 2 No.of Alerting Devices
Tons
No.of Waste Disposers 1 Heat Pump Number Tons KW No.of Self-Contained 7
Totals: Detection/Alerting Devices
No.of Dishwashers 1 Space/Area Heating KW Local 0 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 Data Wiring: 6
Heaters Signs Ballasts 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 ❑ 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: Carl N Nelson
Licensee: Carl N Nelson Signature LIC.NO.: 18334
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 171 ESSEX ST, SAUGUS MA 019064247 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
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: $75.00
i
(lAtl , Nor r (Ari-D ?>64,44s ay e:-40n.j IVAct,pLRtt'�j 10 Syzo
(, 1oi kcftz l
Commonwealth o/KoJachuieth O ccial Use t Only C1�Q
=,r= C�—l�P J Ce
/, �y�` Permit No.
•l- .Z epartment o f%ire Service)
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:09-17-2020
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)51 Bradford Road
Owner or Tenant Gary Mills Telephone No. 617-599-7912
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)
Purpose of Building Single Family Utility Authorization No. 'U-11 L1(k1
Existing Service 100 Amps 120 /240 Volts Overhead Q Undgrd L No.of Meters 1
New Service 200 Amps 120 /240 Volts Overhead Undgrd ❑ No.of Meters 1
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wiring of new addition and remodel and upgrade service
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires 25 No.of Ceil:Susp.(Paddle)Fans 4 Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires 12 swimmingPool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets50 No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches24 No.of Gas Burners No. Initiatinnggon Dete and
In Devices
No.of Ranges No.of Air Cond. 1 Total 2
g Tons No.of Alerting Devices
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers 1 Totals: Detection/Alerting Devices 7
No.of Dishwashers 1 Space/Area HeatingKW Local❑ Municipal ❑ Other
p Connection
No.of Dryers Heating Appliances KW Security Systems:*
tv rY No.of Devices or Equivalent
c No.of Water No.of No.of
Data Wiring: 6
o Heaters KW Signs Ballasts No.of Devices or Equivalent
N Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP
v No.of Devices or Equivalent
>
@j OTHER:
U
'L. Attach additional detail if desired,or as required by the Inspector of Wires.
vEstimated Value of Electrical Work: 16,000 (When required by municipal policy.)
v Work to Start:09-17-2020 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
oINSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
v the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
co
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 0 BOND ❑ OTHER ❑ (Specify:)
cA I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
N FIRM NAME:A and J Nelson Electric Inc. LIC.NO.:18334
"d Licensee: Carl N Nelson Jr Signature Cam_ LIC.NO.:38305
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.'
781-233-1257
Address: 171 Essex Street Saugus,Ma.01906 Alt.Tel.No.:781-884-3939
.'•..t *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
ct OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
Erequired 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. I PERMIT FEE: $