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HomeMy WebLinkAboutBLDE-22-002028 Commonwealth of Official Use Only ' -I. Massachusetts Permit No. BLDE-22-002028 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:10/8/2021 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) 481 BUCK ISLAND RD UNIT 15 fQ©5- (-1CpZ Owner or Tenant Ralph Decker Telephone No. Owner's Address 481 BUCK ISLAND RD UNIT 15EA,WEST YARMOUTH, MA 02673 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&remodel kitchen &bathroo _ T. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 5 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 15 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 15 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 15 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers 1 Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 10 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 Ballasts Data Wiring: 2 Heaters Signs 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: David G Leach Licensee: David G Leach Signature LIC.NO.: 15886 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 770, CENTERVILLE MA 026320770 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:$75.00 I KU CeM le 1(1 ( 7--k 7 1° , C', 313 (A)C!L Commonwealthol f /adeachcsdel �n Official Use Only AL c� Permit No. i C 4F _�, • 2021 2 epartment o/ ire Serviced v �. 11 Occupancy and Fee Checked eu -``' G. HA OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) By ---- 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: /6 e t-2 j City or Town of: V1/3,4 M o t.Z--i 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) ti�'j j?j c�K L S 1�-k RAT CJN i i /S E _, .4-ii€ 'ic' o j fI Owner or Tenant f 4 iti-�)ti j �� Telephone�To. 403 f - 3 i -' Owner's Address .SUM c' Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 1 p P Amps /r_D l 'uU Volts Overhead ❑ Undgrd No.of Meters 1 New Service Amps / Volts Overhead t l Undgrd ❑ No.of Meters Number of Feeders and Ampacity J f5 vii it!) o 4-M r , ,Location and Nature of Proposed Electrical ark: j.c,e 1 A.10 j7 P 71-1-- Q-m 0..42 fM 0P6L /4-/-,e, L o )4-AT 5,, 7.ni-NFL Completion of the following table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of KVA .� Transformers KVA No.of Luminaire Outlets /ej 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 )S No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches .� No.of Gas Burners f#' ik No.of Detection and ' Initiating Devices CAL S/ Totallo.of Ranges ��S No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers ) Space/Area Heating KW Local❑ Municipal ❑ 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: 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: g-a (When required by municipal policy.) Work to Start: j D - t "2_j 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 ❑ OTHER D (Specify:) At,,q t,s Sr Fife-:` i M Cie.;tk Q-y I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: j /a )tij 6,, /�--yl.e Signature, LIC.NO.: l/5-06)'6. (If applicable,a ter"exempt"in the license number line.) Bus.Tel.No.: 5'O8'-3L/-1105% Address: co 13sX ' 0 t 42,VrC7tyi L2.-, AlL � �..O , . Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Departmdnt 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 one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 7 S