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HomeMy WebLinkAboutBLDE-22-007127 3 Commonwealth of Official Use Only _„s"� r Massachusetts Permit No. BLDE 22-007127 ttjj 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:6/9/2022 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) - 61 CEDAR ST Owner or Tenant NAUGHTON KEVIN M Telephone No. Owner's Address NAUGHTON LAURIE A, 11 IRON GATE DR, ANDOVER, MA 01810-1234 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Addition Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 No.of Ceil.-Susp.(Paddle)Fans 1 No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets 10 No,of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 'Ions 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 0 Municipal 0 Other: Connection No.of Dryers Pleating 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 Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 1 nach 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 ❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of pet]my.that the irrforntation on this application is true and complete. FIRM NAME: Licensee: Bryan V Hall Signature LIC.NO.: 55546 (If applicable,enter"exempt"in the license number fine.) Bus.Tel.No.: Address: 7 Plantaion Road, Mansfield Ma 02048 Alt.Tel.No.: 5085622906 *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. 1 :tin the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 1( c) - v i wi RECEIVED rJUN_ l-wl,ctii araice 08 ►; Commonwealth yy� t�ommonweralth eye rrlaeeachneirtte Official Usc Only ,► .t Permit No, . 7/ \ 7 B U I L D I N G D } tr T 2 parinuosi of_ti>,t •s rM < nvrt� Occupancy and Fee Checked ;' /, ;OARED OF FIRE PREVENTION REGULATIONS Rev, 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code M C),527 CMR 12.00 (PLEASE PRINT IN INK©RTiv ALL INFORMATION) Date: 6/3 9, City or Town of: rairlOtj 1) To the Inspector of Wires: By this application the undersigned 'es notice f his or her intention to orm the electrical work described below. Location(Street&N ber) (e e' Owner or Tenant Devi In 4 A Telephone No. ,Ji "no 3JJ' Owner's Address 6( Cedar eafr Is this permit in conjunc on wi a building permit? Yes in No El (Check Appropriate Box) Purpose of Building Kes i d�q-,u I Utility Authorization No. Existing Service t(}t) Amp. l)0 /?UO Volts Overhead Und rd g ❑ No.of Meters New Service (LW Amps 09 kto Volts Overhead (/] Undgrd g © No.of Meters Number of Feeders and Antpacity Location and Nature of Proposed Electrical Work: 04 ;f-I V j\ .44 Completion of the followingtable may be waived by the Infector of Wires. l No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans I No.of Total �,. Transformers KVA c" No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- 'No.of Emergency Lighting +� grid. grnd. Battery Units No.of Receptacle Outlets I c) No.of Oil Burners FIRE ALARMS No.of Zones \`. No.of Switches I. 0 No.of Gas Burners o.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tones No.of Alerting Devices No.of Waste Disposers 'Heat Pump Number. Tons "KW No.of Self-Contained Totals: . Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:*� No.of Water Heaters Signs Ballasts No.of De, No.of No.of Data Wiring:� 'or Equivalent Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP `'I elecommunlca ens irIi : No.of Devices or Equivalent OTHER: (�D Attach additional detail if desired,or as required by the Inspector of Wires. p# Estimated Value gc 'rel Work: o (When required by municipal policy.) Work to Start: (4 313-J— Inspections 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 an BOND 0 OTHER 0 (Specify:) I certify,under the gains and pen es ofperjug,that the information on this application is true and complete. FIRM NAME: OA/CA Yi4ll it iI.Cl LIC.Nth.: 5-8CIt.' Licensee: i3( . 4 Jc tI Signature (If applicable,en��rempt"in a license number line.! / TeL oN. ,%'QS'` (.a Address: / )T( (v ..h1N I,, 0)7`t; Bus.TeL No,: SU�—SG[--IV/6 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety S"License: Alt.Tel.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 eat. Owner/Agent Signature Telephone No. PERMIT FEE:$