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Home My WebLink AboutBLDE-23-002109 Commonwealth of Official Use Only or Permit No. BLDE-23-002109 �`.'� 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:10/20/2022 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) 39 WEST WOODS VILLAGE Owner or Tenant DAVID NORLACH Telephone No. Owner's Address 39 WEST WOODS,YARMOUTH PORT, MA 02675 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: Replacement HVAC 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 TotalTransformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices Space/Area HeatingKW Local 0 Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances No.of Dryers PP KW Security Systems:*No.of Devices or Euuivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Euuivalent 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: Joseph W Silva LIC.NO.: 9147 Licensee: Joseph W Silva Signature (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 ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $50.00 I W , t 0/r14)J2/( YY �,� CP cl�Mas,� Official Use Only • •� 2sipartment o1-ire�apacai Permit No. tid �� !j Occupancy and Fee Checked •;z�;-'-''`. 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 MLEASE PRINT IN INK OR TYPE ALL INFORM4TIOA9 Date: /0 /3-Z Z • City or Town of V)44-in g To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below C Location(Street&Number)37 1<)t ST woof)S &ta .C2- C , ,-0 y S Gc1`A-/e/j 8 Owner or Tenant D A-V/p N o"(A cI- Telephone No. 4 d Owner's Address SAi►'1i- Z Is this permit in conjunction with a building permit? Yes Q No Q------ (Check Appropriate Box) 1Purpose of Building <5i."✓f' f-A-f"t e cr Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters cDIew Service Amps -_ / Volts Overhead El Undgrd 0 No.of Meters 4 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /Z Id 7 le-f_A•acs, •.1T" ,f' P,K,✓ocrz.. t eO•...O ,SLI2 t Completion o,fihe,tollowingtable maybe waived b the bypector of Wires. S No.of Recessed Luminaires No.of Cal.-Susp.(Paddle)Fans No.of t al Transformers KVo Vl No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- ❑ No. Lrrgency Lighting �rgrad. arnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners Na I 1unDeteng D and eiitiatiin�Devices. No.of Ranges No.of Air Cond. Tel No.of Alerting Devices ed No.of Waste Disposers HeatTotals:PumF Number Tons K'OV De ctioof S nIA1e�g Devices � Muni No.of Dishwashers Space/Area Heating KW Local 0 latechocipaCn ❑ Other No.of Dryers Heating Appliances KW Seciritya=or Equivalent No.of Water KVV No.of No.of Data Wiring:Heaters Signs Ballasts No.of Devices or Wiring: quivalent No. No.()Motors Total HP Tel ofile ira o r i�nriivn�l - - r �To�-r►f�'�rir�or F.rynivY�ant OTHER Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:/e)-/ -2 2- 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 C OND 0 OTHER 0 (specify:) (1OM,re c s p., . I ceriify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: .,,1L..Vfi ELF ! JC.. LIC.NO: `V%4/7 Licensee: J bSg-F'jt trJ £it-d+*- Signs LIC.NO:4ZI G e? Of applicable,enter"exempt"in the license number line. Bus.Tel.No.: �2:-F' 70 k, Address: BOt -`f .e�,JONtC( /t7� oz.S'A-s Alt.Tel.No.:So fr.- 3 -'73/i *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 ibis requirement. I am the(check one)0 owner 0 owner's agent. Owner/Signaturegent Telephone No. I PERMIT FEE:$ 411 ��