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HomeMy WebLinkAboutBLDE-23-007357 1 f.' Commonwealth of Official use only 'E.' i ; Massachusetts Permit No. BLDE 22 007357 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:6/22/2022 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) 1 AVERY LN Owner or Tenant Charles Constantine Telephone No. Owner's Address 1 AVERY LN, SOUTH YARMOUTH, MA 02664 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: Remodel basement Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 11 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 20 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 9 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 ,taw 7/CAi -i .- RECEIVED A- Com 'nava +el r//aaeachiuda(fd Official Use Only „ N 212022 ;ia',w�F _2 •artmjnl o`�i,, n Permit No. �j L _ Serviced ...�(_>,i N�$�API�BT1�2 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: 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) f A vie i\t L I Owner r Tenant � „c Q. .5 e. �s..{ .- , lei e.. Telephone No. 6 Q3--7 67 451,17 Owner's Address I Pc/e.4 C 1 ccif Is this permit in conjunction with building permit? ��y o v�� �� � � Purpose of Building r( t � N 0 (Check Appropriate Box) �'iN 4 4 �H t :�,z(A, isS'� .1._ Utility Authorization No. Existing Service j,Q© Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity 12c.-. ti) Location and Nature of Proposed Electrical Work: 136,5., ,A,\R m 1; a c r t (R ‘,1/4,) c it. WA' feu"'1 6, fogiAA va Completion of the followinvable mc�be waived by the htspector of Wires. 9 �� No.of Recessed LuminairesNo.of 'jr .•/ 1 1 No.of Ceil.-Susp.(Paddle)Fans 0 Total �1 No.of Luminaire Outlets Transformers KVA r~\ No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting grad, grnd. ❑ Battery Units ti' No.of Receptacle Outlets 9.,0 No.of Oil Burners FIRE ALARMS INo.of Zones • ... No.of Switches cp No.of Gas Burners No.of Detection and 1 No.of Ranges ( t Initiating Devices 1No.of Air Cond. Tons 7 Tons No.of Alerting Devices No.of Waste Disposers 1 M ons KW eat Pump Number lT No.of Self-Contained 7 Totals:I"-" ...""" 1_ Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal No.of Dryers Connection Other ty Heating Appliances a KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters No.of Data Wiring: . Signs '. Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; No.of Devices or Equivalent OTHER: 1 6t3�1 fpQ 1 c d ti+c.zc e t2 r Estimated Value of Electrical Work: Attach additional detail ifdesired,or as required by the Inspector l 6 r t'I (When required by municipal policy.) P of Wires. Work to Start:45 5,n e f e c t�C1ions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO ERACE: 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: Licensee: IC.NO.: Signature IC.NO.:._.______r (If applicable,enter"exempt"in the license number line.) Address: Bus.Tel.No.• *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.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 owner owner's a ent. Owner/Agent Signature ''7 ;. �,� Telephone No. a 3' 7 7 PERMIT FEE:$