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HomeMy WebLinkAboutBLDE-23-001697_ Commonwealth of Official Use Only k'�{"� Massachusetts Permit No. BLDE-23-001697 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:9/29/2022 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) 25 PAINE RD Owner or Tenant TOM OLIVIER Telephone No. Owner's Address SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ 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: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires grnd. grnd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches 2 Initiatinc Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers totals: Detection/Alerting Devices Municipal 0 Other: No.of Dishwashers Space/Area Heating KW Local 0 Connection HeatingAppliances KW Security Systems:*ances No.of Dryers pp No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Datao of Wiring: or Equivalent Heaters Siens Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: THOMAS J MADDEN LIC.NO. 14065 Licensee: Thomas J Madden Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 *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. I Owner/Agent (PERMIT FEE: $75.00 Signature Telephone No. ce,,,,,ct 9/7,1/..- l2 l l 4---1,14N,_ 1 t s(-0,-, a-- \, Commonwaatt(4 maeeachuaa(e Official Use Only C. ( /_ `� � Permit No. F a fit ,.,,; cc�� gc [[77 m M ;; �Usparfiaa+t o�,tirs Serviced tv-� I� J w Occupancy and Fee Checked ,,_ ;' BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (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: v City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives otice of his or ; ._intention to performe electrical work described below. ----.— Location(Street&Number) J.3 rct t fvi e Qc , .s2 G.,.• ,z, :.;1-4-"N. Owner or Tenant a 4-1A -t- u cl✓c, Q/i i- ' ( Telephone No. '/O/— 7i Owner's Address `7%4 " Is this permit in conjunction with a builds ? Yes 0 No Er. (Check Appropriate Box) Purpose of Building R Q f S'11 I 9 Utility Authorization No. Existing Service /Ct' Amps /c) / :0 VeVolts Overhead Undgrd❑ No.of Meters / N New Service Amps / Volts Overhead 0 Undgrd g 0 No.of Meters Number of Feeders and Ampadty 2 — ///© A Al(.f Location and Nature of Proposed Electrical Work: //i/'/k 6r c/ s'� G( a kid (,✓,✓i Li. et -- C • .,,c- 5 c,rrl e./o rte,--- � /1 c' by 6 c-din r� Completion of the following table may b waived by the In ctor of Wires. tNo.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans Troansformers KVAI No.of Luminaire Outlets � No.of Hot Tubs Generators KVA No.of Luminaires Pool swimmingAbove In- No.of Emergency Lighting grad. ❑ grod. 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 i t! No.of Ranges No.off'Mr Cond. Tunsi No.of Alerting Devices No.of Waste Disposers Heat Pump Num .,ber Tons _KW No.of Self-Contained Totals:, Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municiponnection 0 °tiler C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent _ No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: j/ No.fofrDevices or Equivalent OTHER: 5>i,,� Imo' 1 Gr l j - ��n K roc GAT G} / .' . .01 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lec 'cal Work' y 0 (When required by municipal policy.) Work to Start: In ons to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VE GE: 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 c�ov ga is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE fir BOND ❑ OTHER 0 (Specify:) I certify,under the pains anfi penalties of�,p�r/ury,t the information on this application is true and complete. FIRM NAME: �G cI, e- A /.c. C '` (� L1C.NO.:/7O�,s-)1- Licensee: 1044 , cir(a� Signatu� U.44 C4� LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.• Address: Alt.TeL No.: o _ *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 one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ a