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Home My WebLink AboutBLDE-21-006841 , or _ . 10\4 Commonwealth of Official Use Only Ii l►,�� Massachusetts Permit No. BLDE-21-006841 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:5/25/2021 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) 11 AM NEW HAMPSHIRE AVE Owner or Tenant Paul Cruz Telephone No. Owner's Address 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: New outlets,switches, &fixtu „ 7:: 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. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 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: BENJAMIN NARDI Licensee: Benjamin Nardi Signature LIC.NO.: 50435 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 GREAT WIND DR, PLYMOUTH MA 023602778 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: $250.00 44 Lade (itejt ,?-) Care S G eX D 14_1 Commonweal of/I'/aeeachaeette Official Use Only v. -2C - �gLi ( ti c� r� �a Permit No. a _ .,Lepartment o�gips Jervvicee �' r Occupancy and Fee Checked 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 Cole(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR TION) Date: (c f Z City or Town of: ( 4/`s�v To the Inspector of Wires: By this application the undersign gives notice of his o her intention to perform a /trical work described below. Location(Street&Numb 1 f A)e u i 4,,a,,7f�bc 1./,r'e C Owner or Tenant t" yZ (4 r C c cz'7 // Telephone No.77 Y jr 3 0 573 Owner's Address Is this permit in conjunction with a building permit? Yes No El (Check Appropriate Box) Purpose of Building ��/ 6 ) ei e v.. C. Utility Authorization No. Existing Service __ Amps (2.0 /L 70 Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters I Number of Feeders and Ampacity i Location and Nature�of Proposed Electrical Work: /V,J'<u) 0 (9}1 e.„, ,rLA cf4 e CL� 4� / KP)/ke,� Completion of the follow' • table m be waived the I r of Wires. its y by Total t No.of Recessed Luminaires No.of Cell.-Snap. Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires gy�� p Above In- No.of Emergency Lighting °g grad. ❑ 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 Initiating Devices i i No.of Ranges No.of Air Cond. Ton No.of AlertingDevices Tons No.of WasteHeat Pump Number Tons KW 'No.of Self-Contained Disposers Totals: — Detection/AlerrDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other , Connection No.of Dryers Heating Appliances KW See;1)stem s:or Equivalent No.of Water KW No.of No.of Data Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W �Ing No.of Devices or Equivalent OTHER: Attach additional detail ifdeslre4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: / /k;t, ZOZ.)2/ Inspections to be requested in accordance with MEC Rule 10,and mp 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 insuranceincluding"completed operation"coverage or its substantial equivalent. The undersigned certifies that such -•v= :.a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE !i BOND 0 OTHER 0 (Specify:) I certify,ander the pains and, ,Gies ofperjury,that the information on this application is true and complete FIRM NAME: LIC.NO.: Licensee: e Signature ` LIC.NO.: ' S c) 3 5 "--. (If applicable,Retell'exempt, the erase number line C Alt TeL No.: U 4dMirzarge Y Address: f2 �'-s�I .) y ri ii,lined r.� /.4/J 'Z_S �� *Per M.G.L.c. 147,s.57-61,secut 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. PERMIT FEE:$