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HomeMy WebLinkAboutBLDE-22-000786 Commonwealth of Official Use Only A. i : .' Massachusetts Permit No. BLDE-22-000786 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:8/10/2021 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 wor escribed below Location(Street&Number) 62 GREAT WESTERN RD &Ens6 p0Lt t b� Owner or Tenant CONWAY ELIZABETH L TR Telephon No. Owner's Address 2262 RLTY TRUST,345 CAMP ST UNIT 105,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 647 / 8 9 /6 Existing Service 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 Location and Nature of Proposed Electrical Work: Upgrade service, replacement boiler,dishwasher, &dryer. Install 6 smoke detectors 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 1 No.of Detection and 6 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/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Euuivalent 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:) 7eo 3 7 J-7Vz., I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Joseph J Sullivan Licensee: Joseph J Sullivan Signature LIC.NO.: 6455 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 13 PEBBLE PATH, FORESTDALE MA 026441541 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 v ettgi�376/74 74�) 6CblAs --& 03 fvz ci10#4c- `-S131(� (a0/1,41-4 70r T per) l,ommonweaGth o/Modachuasjio Official Use Only I BUILDING DE TIT h' cc�A gift � By:_— ti A„ le,' �CJs/vartinantol.�"cra�arvresd PcrmitNo. ��r`-�— � 7 �a Occupancy and Fee Checked .- of APPLICATION BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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: c—)0-- ( ,� City or Town of: YARMOUTH To the Inspector of Wires: O By this application the undersigned gives notice of his or her intention to perform the electrical work described below. niC Location(Street&Number) (a a G.iZE to WQ._.1 t e W A Q. Owner or Tenant /1//4/ lt. ,q a 5 Telephone No. IQ l Owner's Address p G/ 7 3Uf-�d�a Is this permit in conjunction with a building permit? Yes ❑ No 0 ? (Check Appropriate Box) Purpose of Building "L 9 p �A,LY Utility Authorization No. 0/ Existing Service mps / ( Volts Overhead❑ Undgrd ❑ No.of Meters v New Service 02V p Amps 11C) / p Volts Overhead Elrd Undgrd® No.of Meters Cy Number of Feeders and Ampadty V i Location and Nature of Proposed Electrical Work: A.fk b, kri `+� Completion of the followingtable my be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Sns . No.of Total 1.fp (Paddle)Fans Transformers KVA 'Z1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA ' No.of Luminaires Swimming Pool Above ❑ In- No.of I mergency Lighting grnd. �rnd. ❑ 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 E` No.of Ran Total es Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Dumber' I Tons KW No.of Self-Contained Totals: " Detection/Alerting Devices $ No.of Dishwashers t/ Space/Area Heating KW Local 0 Municipaln 0 otherNo.of Dryers Heating Appliances 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: OTHER: j • No.of Devices or Equivalent �ptv P I✓(e'c'T vef}L �/ AJj 'oiQ.V1 c — e7© Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: 7CC)c) -. (When required by municipal policy.) Work to Start: ,Q5'/3i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 the pains andpenalties o ) fperJuty,that the information on this application is true and complete. FIRM NAME: J- f c,,)1,,./A A) ^JOrc �j J aV 4 LIC.NO.: Licensee: �(J Signatures,_ � LIC.NO.: -.4 (If applicable,enter"exempt"in he license number line. Address: f 3 Rob /F i}- j, 7-i,y4o���,/ Bus.Tel.No.• - .1.1, *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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: . $ �S,O