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HomeMy WebLinkAboutBLDE-22-005297 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005297 ....- 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:3/23/2022 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) 5&7 JUDAN WAY Owner or Tenant RASMUSSEN NORMAN W JR Telephone No. Owner's Address RASMUSSEN ERMINIA, 759 SPINNAKER CT, SECAUCUS, NJ 07094 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity v ."' Location and Nature of Proposed Electrical Work: Upgrade residence per attach Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires 21 No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Ali: e ❑ grnd. ❑ No.of BatterEUnimer gency Lighting ;,s No.of Receptacle Outlets 25 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 29 No.of Gas Burners No.of Detection andInitiating Devices 1 No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: 1 3 Detection/Alerting Devices Municipal 0 Other: No.of Dishwashers 1 Space/Area Heating KW Local ❑ Connection Security Systems:* No.of Dryers 2 Heating Appliances KW No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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.) y' 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 f' 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. ^�z;J �/'6�� 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: David M Hawkins LIC.NO.: 31112 Licensee: David M Hawkins Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN,YARMOUTH PORT MA 026752252 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: $180.00 I ZF;;Jiz1 6/1i,j Cp.i.4 c k. • ri4) (20 ,c ti (c3 b j 17 t•yy M- C�e-ru,1 cao%,�?��'a ,l) t .66,/,, j t�ox,wonw«si 4//Iaeeacests N© drat U � et ., /�trrr Permit Z / ��- :parfireraE°! Occupancy and Fee Checked /} J� ,.�` BOARD OF FIRE PREVENTION REGULATIONS [Rev.11071 (leave blank) k APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( 2 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR t ON) Date: 1 / 1 City or Town of: ,')2 YYY�� To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrifIl work described below. Location(Street&Number) 11 1 U b ffP (1/If / n�rSo LiIR'12 N'?`out Owner or Tenant;f/f�f�iYr7 Ali 4 j]'j ,14✓jJ/ FA- u sc Telephone No.„co x 0`1 3c.3�' Owner's Address t UC LI_S iv "`\-. C,c7q, 9 Is this permit in conjunction with a building permit? Yes Ej No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. w Existing Service d.(1.) Amps / aO/ fit)Volts Overhead Tal Undgrd 0 No.of Meters a New Service `a.00 Amps ) /t?,'1 Volts Overhead 142r Undgrd❑ No.of Meters I Number of Feeders and Ampadty r01 fjC) 1 Location and Nature of Proposed Electrical Work: 4-\A—P VI Completion of the follawing labls may be waived by the Inwector of Wires. kb No.of ohl No.of Recessed Laminoires p11 No.of Ce l Snip.(Paddle)Fa Transformers KVA V. cA.: No.of Luminaire Outlets No.of Hot Tubs Generators KVA ;', Above In. No.of Emergency Lighting No.ofLaou aaires Swimming Poo. t nd. ❑ mod, ❑ Batter'Units z1 No.of Receptacle Outlets pZ 5' No.of Oil Burners FIRE ALARMS jNo.of Zones No.of Switches a CI No.of Gas Burners PNo.of Initia Detection emand 11.1 No.of Ranges 4 No.of Air Cond. TTonsotal No.of Alerting Devices 1 Heat Pump Ipiumber((T��ons „ KW.. . No.of Self-ContainedNo.of Waste l> Set• Totals:I f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Conn a ❑ Other No.of Dryers a Heating Appliances KW No.oSeeurftyfDevices or Equivalent No.of Water KW 'No.o No. DataWif Heaters Signs BallastsoDevices or t Telecommunications No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Ea , t OTHER: 3Q Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value o El "cal Work: I tJ (When required by municipal policy.) • to be requested in accordance with MEC Rule 10,and upon completion. Work to Start: n permit for the performance of electrical work may issue unless INSURANCE C GE: Unless waived by the owner,no coverage or its substantial:equivalent. The the licensee provides proof of liabi'ty insurance including"completed operation" issuing office. undersigned certifies that such co di is in force,and has exhibited proof of same to the permit CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I cerdfy,under the pains and penaides ofperisem that the information on this application is One and complete. FIRM NAME: J44i u L i - e c ,1--(24 C' 0 n LIC.NO.: Lie.NO.: /ll2- Licensee: t 1) P �`'�lA� �' Signature Bus.Lie. No..:?�i t, ("6%rj Af dreica6le,en,ter"exempt"rn the license number ire Alt.Tel.No.: Address: j`t 7,u7 (, oyli4 nent of Public Safety"S„License: Lac.No. *Per M.G.L.c. 147,s.57-61,security txk requ � OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance o , required by law. By my signature below,I hereby waive this requirement. I am the(check one) 0 owner Owner/Agent Telephone No. (PERMIT FEE:$