HomeMy WebLinkAboutBLDE-20-005324 ,����'/ Commonwealth ofkin
4) Official Use Only
Massachusetts
Permit No. BLDE-20-005324
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRIC 1 J V E D
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 2.
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/7/2020
City or Town of: YARMOUTH To the Inspector of Wires: [ APR92!JBy this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.Location(Street&Number) 24 WHALE RDUILDl1`JC Dl f T
Owner or Tenant COLLINS JAMES F Telephone No. 8 , t
Owner's Address COLLINS SUSAN K,473 MAIN ST, SHREWSBURY, MA 01545
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Aut r' ation No.
Existing Service 200 Amps 240 Volts Overhead 0 No.of Meters
New Service Amps Volts Overhead 0 �j . No.of Meters
Number of Feeders and Ampacity i �/
Location and Nature of Proposed Electrical Work: kitchen, bath remodel fly
U
Completion of the following table may o a IIJispector of Wires.
No.of Recessed Luminaires 10 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- :INo.of E er''', :t.
grind. grind. Battery �tt,�
No.of Receptacle Outlets 15 No.of Oil Burners FIRE ' .
No.of Switches 6 No.of Gas Burners No.of Det a AP Ol?
Initiative Devi ..
No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices 0
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 ❑ Municipal : h
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent 6
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: 04/07/2020 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: JERONIMO A MARQUES
Licensee: Jeronimo A Marques Signature LIC.NO.: 14553
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:26 LAKE AVE,WOBURN MA 01801 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: $75.00
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