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HomeMy WebLinkAboutBLDE-22-000131 UNIT A Commonwealth of Official Use Only 1. Massachusetts Permit No. BLDE-22-000131 .. 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:7/9/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 1039A GREAT ISLAND RD Owner or Tenant Chris Eagan 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 •i 1 f Meters New Service Amps Volts Overhead ❑ Undgrd 4$ .' • ers Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Air conditioning system. �� 0 Completion of the following to a m e ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers40 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 Initiatine 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/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 ofperjury,that the information on this application is true and complete. FIRM NAME: Charles K Swanson Licensee: Charles K Swanson Signature LIC.NO.: 12895 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:718 CEDAR ST,W BARNSTABLE MA 026681300 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 rRECEIVED JUL 0 ' =� AA,, y�j� / • CommonwaQCth o�///aeaachalait0 Official Use Only r _ � (-,V,—© 131 BUILDING D . :` T 2eparinuinfo Permit No }ira Serviced Occupancy and Fee Checked By 7) REGULATIONS 1,OARD OF FIRE PREVENTION "'y [Rev. 1/07] (leave blank) Ci APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK L..- All work to be performed in accordance with the Massachusetts Electrical Code( C),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 ( in City or Town of: YARMOUTH To the Inspector of Wires: N.) By this application the undersigned gives notice of his or her intention to perform the electrical work described below. �, Location(Street&Number) /c 34) G,-t.,... -1.._ (c�id e C - c.,) Owner or Tenant ('I d`i 5 (:^c. G,� - cJ Telephone No. Owner's Address \-1_ l Is this permit in conjunction with a building permit? Yes ❑ No )1 Purpose of Building ❑ (Check Appropriate Box) I Existing Service Amps Authorization No. Ps / Volts Overhead❑ Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead J ❑ Undgrd El No.of Meters Number of Feeders and Ampacity .-- Location and Nature of Proposed Electrical Work: /( ram 'ram A .r- I-&J(z„ i vs 'k� Completion of the following table mg be waived by the Inspector of Wires. i" No.of Recessed Luminaires No.of Cell:Sus . 1T.of .! p (Paddle)Fans Transformers Total "=;t No.of Luminaire Outlets KVA r No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of IN mergency Lighting grnd. and. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and s° No.of RangesInitiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump W DNo�of Self-Contained Totals: .................. No.of Dishwashers , e ection/Alerting Devices Space/Area Heating KW Local❑ Municipa No.of Dryers Connection ❑ ome, iY Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent HeatersNO °f KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring; OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: S (When required by municipal policy.) Work to Start: -2' 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify under th aims and penalties operjury,that the information on this application Lc true and complete. 2 c ' !! p JC FIRM NAME; ✓tci/`,('C S J GJ c,✓\ Sc ill 7 Licensee: 4,7„, LIC.NO.: Signature-' c.. �"`" LIC.NO.:;. .S t C�t (If applicable,enter"exempt"in the license number line.) Address: Bus.Tel.No. '716 Alt. *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 owner owner's a ent. Owner/Agent Signature Telephone No. p PERMIT FEE:$