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HomeMy WebLinkAboutBLDE-21-005692 ` - Commonwealth of f� Official Use Only � Permit No. BLDE-21-005692 Massachusetts 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:4/2/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 12 MERGANSER LN Owner or Tenant Dorian Carbunari Telephone No. Owner's Address n Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec 1,6 ®Purpose of Building Utility Authorization No. / Existing Service Amps Volts Overhead 0 Undgrd 0 ► sty , / - New Service Amps Volts Overhead 0 Undgrd 0 'f , s AU. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC. 8,64,-,•?.- Completion of the following table may be waived b •,ys r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 'fdt Transformers 'A 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons 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 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: 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOSEPH V SLOWEY Licensee: Joseph V Slowey Signature LIC.NO.: 11186 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 WATERCOURSE PL, PLYMOUTH MA 023603629 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 _i Commonwealth.o/Mamachivae Official Use Only i _:-,' 2e artment o f.}ire�eruices Permit No. ;?� � �� Occupancy and Fee Checked sls 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: 3,3a , 071 City or Town of: 'a C YYl O v\ T \-4- 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) I a M ev3a ii s e r L r'I e w 'th. mo uT-I-f Owner or Tenant c, f►Gt( Ca rb A n cA�1 Telephone No.47i7, di?/•03 dy Owner's Address Is this permit in conjunction with a building permit? Yes n No © (Check Appropriate Box) Purpose of Building eeS,,e Ac P Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: co t re A e. I c115C0nneC 1- and ,girnGN ,e, 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 V 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 . b No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones 8 No.of Switches No.of Gas Burners No.of Detection and No.of RangesTotal Initiating Devices No.of Air Cond. Tons No.of Alerting Devices V No.of Waste Disposers Heat Pump I Number i Tons IKW No.of Self-Contained Totals: Detection/Alerting Devices Q) No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other L.r No.of Dryers Heating Appliances Security Systems:* �-0 No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 0 OTHER: Q) No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: � No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (g. '— (When required by municipal policy.) 7 Work to Start:`]'30 i a( 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. W CHECK ONE: INSURANCE j BOND ❑ OTHER 0 (Specify:) QI certify,under the pains and penalties o fperjury,that the information on this application is true and complete. FIRM NAME:J Us -EI e c'fir lc t ci h Licensee: i/ LIC.NO.: S lb t li Signature � ,I� V�����M '' LIC.NO.: ill�!o/� (If applicable,enter "exempt"in the nse number Izjte„) � �/(� D w Address: (10 R wad ereoUt 5e elate p VI IYIoU YY1G. D [ad Bus.Tel.No.;57)8, (0'adSa *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public SafetyAlt.Tel.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 ❑owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ r--