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Home My WebLink AboutBLDE-21-006350 Commonwealth of Official Use Only 1.L Massachusetts Permit No. BLDE-21-006350 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:5/4/2021 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) 27 CAPT WEILER RD Owner or Tenant KHALIL SAID G Telephone No. Owner's Address FARAG PANCY M, 27 CAPT WEILER RD,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check r .I I I 0 441 •. Purpose of Building Utility Authorization No. ;e ti .:. ay Existing Service Amps Volts Overhead 0 Undgrd 0 ' 'o I 'OW New Service 100 Amps Volts Overhead 0 Undgrd 0If .o T ,� Number of Feeders and Ampacity8 , Location and Nature of Proposed Electrical Work: Upgrade service. b Completion of the following table may be waived : i<,•oVr or Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans NTransformers ds an ` 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 Init ati of netDevices ection and No.of Ranges No.of Air Cond. Tons Tot No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Heating Local ❑ Municipal ❑ Other: No.of Dishwashers Space/Area KW Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts 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.) 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: Lloyd R Smith LIC.NO. 15688 Licensee: Lloyd R Smith Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:Address:30 1ST ST, MELROSE MA 021764010 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 'PERMIT FEE: $50.00 I Signature Telephone No. 2 ,t5-0--—CPS p 0. okfitie. Pie r1 i z e CammonweaJlh o/Mamach.toett.1 Official Use Only _* c7 Permit No. L% -P` -5 SD 1 =•- 2epaw$menl ol..tire Semicea r i Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC 5..7��.0 I I . (PLEASE PRINT IN INK OR TYP ALL INFORMA Date: City or Town of: �V 1 O U� .1 ' To the Inspector of Wires: By this application the undersigned gi es notice of his or her intention to perform the electricalworkdescribed below. Location(Street&Number) 2� W�% 1"t V Owner or Tenant �� "� i 1 Telephone Notg, )4 Owner's Address VUJ a,bat,J`C _ Is this permit in conjunctio with a building permit? Yes n No n (Check Appropriate Box) ( ^ �5 Purpose of Building ,Dui 1 I t Utility Authorization No. , GC 3 I V Existing Service 1�Amps � � / ! V�olls Overhead Undgrd No.of Meters I New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: 0 CO a 1 f SCE .J ,. r J Completion of the following table may be waive the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA 5. No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- n No.ofEmergency Lightinggrad. grad. Battey 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 Tot al Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices r Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: -Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local E] Municipal ❑ Other J Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW Data Wiring: if Heaters Signs Ballasts 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.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE.RA E: 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) '0. I certify,under th pains and penalties of per' ty that the information on this ap 'cation is true and complete. FIRM NAME: Vi V 1 1 & ,Vt� LIC.NO.: Licensee: ,0.4a 5on e Signature LIC.NO.: _ W:t 'If applicable.enter "exempt"in the license number line.) Bus.Tel.No.: 0. Address: OCiT L11) S ig1 l Gi ) Alt.Tel.No.:a `-Q5 "-rrl *Per M.G.L.c.'147,s. 57-61,security work requires Department of Public Safety"S"License: 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $