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HomeMy WebLinkAboutBLDE-21-007468 Vi ° Official Use Only ,� _ Commonwealth of _ Massachusetts Permit No. BLDE-21-007468 ' ' 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:6/22/2021 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 describefl below. � Location(Street&Number) 98 IROQUOIS BLVD l (� Y fa - Owner or Tenant Telephone No. Owner's Address J&-P . 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: Replacement panel. 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- CINo.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. 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Michael A Lenihan Licensee: Michael A Lenihan Signature LIC.NO.: 52081 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 MATHER DR,WAREHAM MA 025711942 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 ci_. 30P --- `irp C) ,' �� �� Cal �.'.., � , � a b ftD gpgpgpl , o Commonweal o/i//aeeaclumette Official Use Only ," ,/ c7 ;s�' .. ,_ 2eparttsneni e�.t „Y Permit No. 1 E �" ` 1; —, i 1 u+s ervkse ' : . BARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (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: 4/ /� / 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) QYro7;,o S R/✓cj Owner or Tenant /v,,y 1,4,f.,, s, Telephone No. 6/7_3 VD-0/-1-,3 Owner's Address Is this permit in conjunction with a building permit? Yes 0 No I (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /OO Amps / Volts Overhead Er- Undgrd 0 No.of Meters / New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ` -1, /L f And / ('.�p�..�cPJ77..r7�. _�i7 � .r c, Completion of the followinttable mo.,be waived by the',vector of Wires. vo lb No.of Recessed Luminaires No.of CeiL-Soap.(Paddle)Fans No.of Total z- Transformers KVA �1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA r� Pool Above In- ❑ No.of Emergency Lighting 4.: No.of Luminaires Swimmingthud. � grad. 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 t I! No. Devices Tota No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Hat Pump Number Tona W No.of Self-Contained Totals:( i' """ '"'.1"""""' Detection/Alertinapevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection 0 other No.of Dryers Heating Appliances KW Security gystems:* 1 No.of Water KW No.of No.of Devices or Equivalent 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: GOO (When required by municipal policy.) Work to Start: (o;.;2/ y, ,2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: Unless waived by the owner,no the licensee provides permit for the performance of electrical work may issue unless 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 EV.BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: / LIC.NO.: '/;t Licensee:/ fiA.',/ ter.),-JAn Signature (Ifapplicable,enter"exempt"in the license number ling.) ,� LIC.NO.: 5 d�l Address: ('7 //y ji�1 ai i/�, �. c�se; 3 • Bus.Tel.No.: 7"7y-�s.3(i 4,2 lal 3 *Per M.G.L.c. 147,s.37-61,security work requires Department of Public Safety"S"License: Alt.Lic.No. �• OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ni o—rntaily required by law. By my signature below,I hereby waive this requirement. (check Owner/Agent I am the one)0 owner ❑owner's agent. Signature Telephone No. I PERMIT FEE:$ 50