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Home My WebLink AboutBLDE-21-007159 o' '�j �� Commonwealth of Official Use Only R� aigli1' Massachusetts Permit No. BLDE-21-007159 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:6/9/2021 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) 15 EVERGREEN ST Owner or Tenant EVERGREEN STREET RLTY TRUST Telephone No. Owner's Address 90 ASHTEAD RD, BRIDGEWATER, MA 02324 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 ❑ 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: gt.condenser. 51 j,j.-r , {:17,„r 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 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 ❑ 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 ,Siens 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 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 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 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: $50.00 c9 & (04(74 -1Z.F-At (/ / r. U 7- Fla, ,g- &zl4-1/14-4- AS.,at- (_'_ �` -F-L,/�- ✓os (..otnnwnweallk o j Madoaclu..446 Official Use Onlyiz lg+ Y Permit No. 2— 7 L/ 7 2)eparimant o/.iPs$civics! Occupancy and Fee Checked . _ ,.'' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07j (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: —/—Z1 City or Town of: ' 4 f •wlOL 7kf 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) /r .✓0.-? / .� _c_ / 0 . Owner or Tenant n�g...t ��.rg Telephone No. d Owner's Address . >,��,._ F Is this permit in conjunction with a building permit? Yes ElNo [(Check Appropriate CI Purpose of Building S/ 7�� PP priate Box) f Utility Authorization Na q Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters VI v New Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters 4 Number of Feeders and Ampacity 4 Location and Nature of Proposed Electrical Work: u,,„i ,,/6„) 47L tip,J,, c 4 j _ Completion of the,following.table may be waived by the Inspector of Wires. V)1 No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of fiotal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting Alt! ❑ 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. Tool Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW N.of Self-Contained Totals:_ ,Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection Connection Municipal ❑ °ther No.of Dryers Heating Appliances KW Security of or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of evices or E�quivalent I. Wiring.. No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equient OTHER: Attach additional detail if desires!or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: .. r Z-/ 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 covers a is in force,and has exhibited proof of same to the permit issuing offic . CHECK ONE: INSURANCE BOND CI 0 (Specify:) eO�/n; :�C6 .. is Z,,0, I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: .S/t..,VR- ELEL f/L/C... LIC.NO.:/b?/477 Licensee: .3 e sE-p ht t,.J £t..via-- Signatu — LIC.NO.:. Zi6 V.? (If applicable,enter"exempt"in the license number line. Bus.Tel.No.:�k'`t Z-g'"9'a'F' Address:(le) O 4g-y 2tO . .9^i.�'✓(Gt /1?•9, 02-5'4 Alt.Tel.No.�2 344."I-931 *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: $