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Home My WebLink AboutBLDE-21-002706 Rh Commonwealth of Official Use Only O Massachusetts Permit No. BLDE-21-002706 ltli 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:11/12/2020 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. I-' ,�0 . r2-mil� Location(Street&Number) 66 NOTTINGHAM DR SbR' -+/!f/ Owner or Tenant Jim Saben Telephone No. Owner's Address 66 NOTTINGHAM DR,YARMOUTH PORT, MA 02675 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: Install sub panel&wire basement as needed. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool grade 0 grnd. ❑ No.of Battery Units Emergency Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Space/Area HeatingKW Local ❑ Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP 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: ALAN R O'REILLY Licensee: Alan R O'Reilly Signature LIC.NO.: 51570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 LENTELL ST,SANDWICH MA 025632116 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 jo 0/4/(gli /Z� ' coautionewmaKo////eased Official Use Only ' 'r PernaitNo ` `L70G_7 sparinsrtf � k Occupancy and Fee Checked 1/41/4 'ice i BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07•) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 3 All work to be performed in with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I i i a ac City or Town of: LI a �-r To the Ins et .o Wires: By this application the undersigned gt s notice of his or her intention to perform the electrical work described below. �.; Location(Street&Number) (cto 0(Tha hrbw► ("v-c _ sk Owner or Tenant �,M S e.,n J Telephone No. )'737.0ay 0 Owner's Address cs.S eAck-,.rP Is this permit in conjunction with a building Yes, No 0 (Check Appropriate Box) .1 Purpose of Building rn.S\p._dk ` 0.Sev"e+ A�t.W Utility Authorization No. '' Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters �' New Servjee Amps / Volts Overhead[,0' Undgrd � No.of Meters -`, Number of Feeders and Mnpaclty Location and Nature of Proposed Electrical Work: n.. ,n e r a w+.w rot, a S cc ei rrt.S Completion of thefollowi table omay be waived by the inspector of inires.' t4,1 No.of Recessed LuminairesNo.of Cent.- nsp.(Paddle)Fans ,Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Poole 1-1`IIn- p No.or Ulr 'righting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones nd No.of Switches No.of Gas Burners "No.I�tingDevf Detectionices IV No.of Rouges No.of Air Cond. T°0ntdi No.of Alerting Devices No,of Wastem Heat Pump Number„Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 C nnnection L 0Wer No.of Dryers Resting Appliances Kw "Security S ,_4`+ No.of Ater , o, .,itio.of No.of : .;. or Equivalent Data Wiring. Heaters KW signs< Ballasts No.of�or Equivalent dcatiom No.Hydro Bathtubs JNo.of Motors Total HP Teleco Na.oaf uD or Eq nt OTHER: Attach additional detail tf deeired,or as required by the Inspector of it'lree, Estimated Value of El ' ` Work: it 5o7Jt (When required by municipal policy.) World to Start: II 4 O hype ctions to be requested its accordance with MEC Rule 10,and>upon completion. INSURANCE CO GE: 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 ftt�i the permit issuing ffice. CHECK ONE: INSURANCE,K BOND [3 OTHER 0 (Specify:) a a,r r 12 2 0 I cct7(Jy,under the pains Pc a pe ry,that the l njutstratlott on this o is true and opkte. FIRM NAME: .w`. . •\ Ali - _ ` ` e.) _../ LIC.NO. Licensee: ', /t d E. , Signature LIC.NO.: • c5i5r10 (If applkable,enter"ere,,t"n the icense ,_ line.) Bus.Tel.No.:. Address: v► s r1..-. 6%31(1., MA Oc .5& Alt.TeL No.: 13 *PerM.G.L.c. 147,s.57-61,security work requires Departntent of Public So'... S"License: Lie.No. OWNER'S INSURANCE'WAIVER: I am aware that the Licensee doer not have the liability insurance coverage normally required bylaw. By 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:$