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HomeMy WebLinkAboutBLDE-21-006424 c.. 4 l Commonwealth of),iptx Official Use Only � ~:.. Massachusetts Permit No. BLDE-21-006424 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:5/6/2021 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 e ow. Location(Street&Number) 8 CUTTYHUNK LN In r—�j,2_--- S.7 Owner or Tenant Donna Skuncik Trust 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: Install sub panel, lights, receptacles, &heat. 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 VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergenc ig ng grnd. grnd. Battery Units .t' No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALAR '�y ��,.ofs `� No.of Switches 4 No.of Gas Burners No.of Detection ' • Initiating Devices �O; �� No.of Ranges No.of Air Cond. Total No.of Alerting Device �'.0 ��j Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained A) Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Ot Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Data Wiring: 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 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. t `�2I' ©9 3 5 FIRM NAME: Joseph T Mark Licensee: Joseph T Mark Signature (If applicable,enter"exempt"in the license number line.) Tel. NO.: 35739 Address: 100 WILSON ST, HOLLISTON MA 017461434 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 r 7(( /24 • +_ C,omn+onweaGth o i! �,=51 /t/a��achcs�ef Official Use Only , C 5 Q �t�= l s' Permit No. 1. — � . -*. , ?* ePartmenl o fire erviceb +- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ``t�4 '- APPLICATION FOR PERMIT TO PERFORM[Rev. 1/07] leave blank All work to be performed in accordance with the Massachusetts ELECTRICAL WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION 21 /2 21 CMR 12.00 Dat City or Town of: YARMOUTH e: 4/ / 0 To thebispecto By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 8 CUTTYHUNK Owner or Tenant L. Owner's Address Telephone No.74 105— 471(17 Is this permit in conjunction with a building permit? Yes 0 No Purpose of Building STORAGE SHED 0 (Check Appr Box) Existing Service Utility Authorization No. 49 Amps / Volts Overhead 0 Undgrd New Service Amps / g ❑ No.e 1� • Number of Feeders and Ampacity —Volts Overhead 0 Und rd \• <0t g ❑ No.of r ,_Location and Nature of Proposed Electrical Work: 30 AMP SUB PANEL, LIGHTS, RECEPTACLES H�F� IV Com,letion o the ollowin• table ma be waived b the Ins,ector o 'Tres. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.o otal No.of Luminaire Outlets N Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires 8 SwimmingPool 'ove n- ❑ 'o.o mergency g, ng No.of Receptacle Outlets 7 rnd. rnd. Batte Units No.of Oil Burners - --- No.of Switches FIRE ALARMS No.of Zones 4 No.of Gas Burners o.of i etection an, No.of Ranges Initiatin Devices No.of Air Cond. ota T'eat Pump Number ns ns No.of Alerting Devices " i o.o elf- ontained No.of Waste Disposers Totals: .. """" No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW umc� al No.of Dryers HeatingAppliances Local Connection ❑ Other echNo moo,of ater PP KW h' stems: Heaters KW No.o Si,ns Ballastso.of Devices or E uivalent o.o Data Wiring: No.Hydromassage Bathtubs No.of Devices or E uivalent No.of Motors Total HP of Devices a ecommunications Wurmg: OTHER: No.of or E,uivalent Estimated Value of Electrical Work: $4500 Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: 4/2ec 21 (When required bym Inspections to be requested in accordance ith MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work the licensee provides proof of liability insurance including coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuin`completed operation" office may issue unless CHECK ONE: INSURANCE 0BOND I certify,under the pains and penalties o El OTHER ❑ (Specify:) g ' (perjury,that the information on this application is true and complete FIRM NAME: JOSEPH T MARK LICENSED ELECTRICIAN Licensee: JOE MARK LIC.NO.: 35739 E (If applicable,enter"exempt"in the license number line.) Signature } Address: 100 WILSON ST HOLLISTON MA 01746 Bus.Tel.No.: 35739 E *Per M.G.L.c. 147,s.57-61,security work requires De774-217-pg35 OWNER'S INSURANCE WAIVER: Department of Public Safety" „ Mt.Tel.No.: I am aware that the Licensee does not have the liability insurance coverage normally required law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent Signature owner ■ owner's a ent. Telephone No. PERMIT FEE:$