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HomeMy WebLinkAboutBLD-22-002643 Commonwealth of Official Use Only or )fink ; Massachusetts Permit No. BLDE-22-002643 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:11/9/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 71 DIANE AVE Owner or Tenant Jonathan Lowery 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: Remodel bathroom 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 Initiatine 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 ❑ 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 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: Ruy Batista Coelho Signature LIC.NO.: 56863 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 15 Namcy St, Hyannis Ma 02601 Alt.Tel.No.: 5085555555 *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:$50.00 C 4tc o' 1� 4474 (_ "0 Rye rn4r CA7 ( (Ali [ l CouL( Commonwealth.o`///aeeaciaesiie Official Use Only 'J ,LZ¢ r t B c� Permit No. `�l Is spartmni o/ }irs-Ssrvicsd Occupancy and Fee Checked , . BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) o APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK l3 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:�fi--Z - Z 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) 7/ pi 0.vi e iQ ve S ye.r,,-7 pv oz,(('y Owner or Tenant .6•16140 H LO t e'R Y sv Telephone No. 7/7z/ fZL —1382 Owner's Address / ,Z,a rs C ,4 cf C s/v�r A''ZOv7`4 Is this permit in conjunction with/a building permit? Yes 0 No !CM (Check Appropriate Box) W Purpose of Building t�e 5 r Jell Ci 4 L tUtility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd New Service g ❑ No.of Meters Amps / Volts Overhead 0 Undgrd 0 No.of Meters t Number of Feeders and Ampadty vt Location and Nature of Proposed Electrical Work: ,Bl, r ke‘''-t0Ofie L * Completion of the followinktable mf be waived by the Inspector of Wires. Lb No.of Recessed Luminaires No.of Ceil.-Soap.(Paddle)Fans No.of Total Transformers KVA C1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA Ak No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Unitsency Lighting �t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS lNo.of Zones No.of Switches No.of Gas Burners No.of Detection and 1:1 No.of Ranges Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW *No.of Self-Contained Totals: " _..__ ( J 1 T I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munidpal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromaasage 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�t�r (When required by municipal policy.) Work to Start:/0—Z 6-II Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no pennit 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: ' v7` ��Oet,� Signature LIC.NO.: (If applicable,eter�' mpt"in the li ense number e lh 5 _ 0 60� eevt LIC.NO.:S� 3 Address: /f Na Cys 40Ae `/ Bus.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.TeL No.: 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. PERMIT FEE:$ r . .