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Home My WebLink AboutBLDE-22-001202 Commonwealth of Official Use Only 4-, Massachusetts Permit No. BLDE-22-001202 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:9/1/2021 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) 21 NAUTICAL LN Owner or Tenant ANGLIN FRANCIS X Telephone No. Owner's Address ANGLIN EUGENIA F, 21 NAUTICAL LN, SOUTH YARMOUTH, MA 02664 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: Mini Split NC 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 Initiating Devices No.of Ranges No.of Air Cond. 1 Tonal 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 Ballasts Data Wiring: Heaters Signs No.of Devices or Eouivalent 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 ofperjury,that the information on this application is true and complete. FIRM NAME: JOSEPH W SILVA Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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 C (( cC)1(-4l')1v, c6 -4°y Ccco OctQdta� /Official Use Onlyly - `` 2ioartaront 0 Service3 Permit No. �= �� (Q�' i i-`k Occupancy and Fee Checked. - t .. ,, BOARD OF FIRE PREVENTION REGULATIONS [Rev,l/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g-- 2 7W- z-/ • City or Town of: e.r/14 ' To the Inspector of Wires: By this application the undersigned g /es notice of his or her intention to perform the electrical work described below. 4 Location(Street&Number) 2 I /tat- /t;`1.L. 1--AJ Owner or Tenant (' 1 — ,1-A 1, Telephone No. Owner's Address 54 41C- E Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) ci cl Purpose of Building /,Si .v7i 44 . Utility Authorization No. 4 Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters v New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters 4 Number of Feeders and Ampacity i4 Location and Nature of Proposed Electrical Work: i, /V' 7- d j Completion ofthe followingtabk maybe waived by the Inspector of Wires.N s No.of Recessed Luminaires No.of Cen7.-Susp.(Paddle)Fans TransoTotal ,Trn formers KVA No.ofLuninaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lightinggrad. grad. Battery Units ___, No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches Na of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Na of Alerting Devices No.of Waste Disposers _ Heat Totals: Number Tons C No of ontained — Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ MIciPaleetion ❑ Other No.of Dryers Hating Appliances ICW No.of Dec or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.o ices or u • lent Telecommunication I No.Hydromassage Bathtubs -No.of Motors -Total-HP--- No.of Devices orE_gn�t OtHER: Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Z 7 Z1/ 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 �� . CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) eamfizr ZC4 S o _ _ I certify,under thepains and penalties ofperjury,that the information on this application is true and consptere. FIRM NAME: $1L,Vft j_L. l e—/C-- LIC.NO:/4-?/` 7 Licensee: J�SE.ra jt .�u- VA— Signa LIC.NO:LZiG � (If applicable,enter`exempt"in the license number line. Bus.Tel.No.:�� z``f g''�t`ee e. Address:;30 23Or1�- l�-1 AO 6-.a e! Abe- oZ�'iE 3 AIL Tel.No. 3(... 73/ *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the ally required by law. By my signature below,I hereby waive this requirement I am the(check )❑owner insurance co0�' ownege rs agent. Signature �Aegent Telephone No. IPERMIT FEE:$ I