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HomeMy WebLinkAboutBLDE-22-004489 Commonwealth of Official Use Only I Massachusetts Permit No. BLDE-22-004489 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:2/14/2022 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) 64 KINGS CIRCUIT Owner or Tenant GREEN COMPANY INC Telephone No. Owner's Address 46 GLEN AVE, NEWTON, MA 02159-2066 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: Remove and replace exterior equipment for siding. 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- ElNo.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 Initiating Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Clifford E Archer Licensee: Clifford E Archer Signature LIC.NO.: 14688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 175 E MAIN ST, NORTON MA 027662420 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: $80.00 • RECEIVED A FEB 112022 C numanh o` /addacbudl[e Official Use Only `S aING UEPARTM •Gs,, c� Permit No. E/ZZ- 4 tmsnE o f emirs&rvicsd ,; _al:: OF PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PE All work to be performed in accordance with the Massachusetts PERFORM ELECTRICALcal Code( EC) 527 CMR WORK .,zJ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ) City or Town of: Date: � "/�� 2 By this applicationy orthe undersigned givYARM his OUTHintention to To the Inspector of Wires: x. Q Location(Street&Number) 4) notice; C'- perform the electrid work described belo v Owner or Tenant 1 Co,-a A e cuc i1 Owner's Address Telephone No. Is this permit In conjunction with a building permit? Yes t Purpose of Building 14 St-og A ' .� No ❑ (Check Appropriate Box) o '•'t 'R Utility Authorization No. oUndgrd Existing Service 10U Amps 171Volts Overhead 0 s New Service a-- No.of Meters U Amps / Volts Overhead❑ Undgrd❑ No.of Meters t Number of Feeders and Ampadty beS6 /1L al A Location and Nature of Proposed Electrical Work: ►'►L° Si 1 v< Re 5 iSv .(-n'i.o, 0 ie,A Iii�h�oti 1� V'1 •-c3 5 r - i t Lb,tee Com./etion o the ollowin_ table m be waived b the In ,ector o Wires. No.of Recessed Luminaires No.of Ceil.-Sus . p (Paddle)Fans '°•° ota No.of Luminaire Outlets Transformers KVA ev No.of Hot Tubs Generators KVA' No.of Luminaires Swimming Pool 'Ve n- o.o mergency n nd. ❑ and. 0 Butte Units g `} No.of ReceptacleL. Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o t etec+on an 1 r No.of Ranges Initiatin. Devices No.of Mr Cond. ota Tons No.of Alerting Devices No.of Waste Disposers Totals:'eat 'amp `um er ons ' �'___._...._._..............._.._....._. o.o e mita n No.of Dishwashers Detection/Aiertin Devices Space/Area Heating KW Local 0 'un p No.of Dryers Heating Appliances eca Connection ❑ Other Connection o "a er KW h' ye Heaters KW °•o °•o No.of Dstevims:ces or E uivalent S AS Ballasts Data Wiring: No.of Devices or ' .uivaleut No.Hydromassage Bathtubs No.of Motors Total HP e,common ca+ons " r ,gg OTHER: (� • ��o i No.of Devices or E.uivalent 2weta t+ q Ardi-v.0'„1pe1-5 1 t=u 's ,2 Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: %1 -c? -aCi Work to Start: ©G' (When required by municipal policy.) INSURANCE COVERAGE: Unesspwaiv d by the ownerections to be requested permit in for the performancece with of electrical work wocompletion. ss 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.may issue unless CHECK ONE: INSURANCE (BOND El OTHER I certify,under the0 (Specify:) P,tj� and pepal fperjury,that the Information on this application is true and complete. FIRM NA WEt l I k lb v t. 1 n,c Licensee: e.... t '„ l`t rdla/ LIC.NO.: 4 I - Signature _____________ (Ifapplicable enter"exempt',ip Jhe I/c e n er hq e.) LIC.N0.: 3/0 3 y Address: �7 , /"l ;., o ' Bus.Tel.No.: c' S*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety..S"License: Lic.Alt.Tel.N No. —" � o��S- �sl OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insuranceoverage normally reguired 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:$