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HomeMy WebLinkAboutBLDE-22-001126 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001126 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:8/30/2021 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) 41 CAMP ST 7,5-tp531, Owner or Tenant BAKER JOHN M TRS Telephone No. Owner's Address BAKER ELIZABETH A TRS,41 CAMP ST,WEST YARMOUTH, MA 02675 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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 Heat Pump Number Tons _ KW No.of Self-Contained No.of Waste Disposers 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 ❑ 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: JOHN H BREWER Licensee: John H Brewer Signature LIC.NO.: 14092 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 CEDAR ST,W BARNSTABLE MA 026681324 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: $50.00 NI74- g73072, e c°t > /<( Commonwealth o////assactts Official Use Only a -* c� c7 E-i 22i t dJepartment a/ ire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �2..., [Rev. Il07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: e.? / City or Town of: V6 To the Ins ector f Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ✓ f (,7/'11 aJ Map Parcel# Owner or Tenant C44/`- ✓ /k--G-ar Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box ) Purpose of Building R L/.. /gyp/ t Utility Authorizati9 No. � Existing Service/7'a Amps/ '/oQ'.(Jolts Overhead E74' Undgrd No.of Meters New Service /C:70" Amps/4J tt(&-Volts Overhead❑ Undgrd [? No.of Meters I Number of Feeders and Ampacity ,.3 S V CI Location and Nature of Proposed Electric Work: J d 1===.4,j c 1.i�✓i1 k- /^ <7� V L �/ 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 Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs Generators ICVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grnd. .Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.olDetection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: "M"_"'"'" """"'"'__."' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other, No.of Dryers Heating Appliances KW `security Systems:* No.of Devices or Equivalent No.of Water No.of No.of HeatersKW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin 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: 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 force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the`information on this plication is true and complete. FIRM NAME:c 0 ff�t 0/Nl ti/:;?-( � kI l R kyitlit;k7 Wj LIC.NO.:t"2 I9`ti g. Licensee: iLL:..P/ 9 4L, Signature .4.4—...-- LIC.NO.:E/L(p 9.,„„z (if applicable enter"exempt"in the license number line.) Bus.Tel.No.: Address: 111 LI =. / 04 t.Tel.No..$©g31p ©/(yi *Per M.G.L.c. 147,s.57-61,security work requires Department of 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 Owner/Agent one)❑owner Downer's agent. Signature Telephone No. I PERMIT FEE: $ *IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Alarm inspections are performed by the FD having jurisdiction.