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HomeMy WebLinkAboutBLDE-22-000167 a~1 -.,e-,..1 h i.i:3 7, . j 0 Commonwealth of Official Use Only , , � t Massachusetts Permit No. BLOE-22-000167 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:7/12/2021 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) 18 VACATION LN Owner or Tenant Edward Shea Telephone No. Owner's Address 18 VACATION LN,WEST YARMOUTH, MA 02673 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 150 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service 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- ❑ 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 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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: 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: Stephen M Peckham Licensee: Stephen M Peckham Signature LIC.NO.: 19877 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 367,CENTERVILLE MA 026320367 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 (SZ, ‘ ,..1,— '7(14('Ix tr---g CuEIGrir 0 P11. f1) cvLol ,at) : . 4* giz$(2 1 RECEIVED J U L 0 9 CA Comnwewrsaftt<4 rr/aaeuci�uca ha Official Use only EeZzBUILDING Disi i T it 1CM Permit No. —C t01 By Occupancy and Fee Checked "A.,...,I BOARD OF FIRE PREVENTION REGULATIONS [Rev, 1/07] (leave wank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical coii.(MEC4;527.CMR 12.00 r.. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /' , ,,,i City or Town of: ` ` L'' �. �1� To the Inspector tress By this application the undersigned gives notice of has or her intention to perform the electrical work described below. Location(Street&Number) f'`� . . a, Y Eli . 1'L. ` . SKYr L: ✓i Owner or Tenant is .! "' -y \ ,,L..'',C t i'( j eP -4 :: `, ' , , li-_-,. l K (� ."C..,d.:� i Telephone No. ' i Owner's Address U this permit in conjunction, with a building0 permit? Yes No : (Check Appropriate Box) Purpose of Building Jam`,1 , -,,4; Utility Authorization No. Existing Service Amps i Volts Overhead 0 Undgrd 0 No.of Meters New Service 1. Amps i:';`._ / . -' Volts Overheada, Undg rd 0 No.of Meters Number of Feeders and Mupaclty Location and Nature of Proposed Elechier d Work: ,,,,,- - w • '' r' ♦♦ i I Completion of the following table+ny be waived by the InTend spector of Wires No.of Recessed Laminalres No.of Ctn.-Snip.(Paddle)Fans To.of KVA To. KVA CIinat No.of Lnmre Outlets No.of Hot Tubs Generators KVA No.of Luminaires Above Ise- 'No.et Emergency Lighting Swimming Pool-and. 0 fund Q Batter/Units No.of Receptacle Outlets No.of O8 Burners FIRE ALARMS No.of Zones t. No,of Switches No,of Gas Burners No.of Detection and + Initiating Devices I No.of Ranges No.of Air Cond. Tons No,of Alerting Devices -Heat Number_Tons KW 'No.of Self-Contained No.of Waste DisposerTotals: __.___._ .�. Detection/Ale . Devisee No.of Dishwashers Space/Area Heating KW Local Mu, , 1' 0 Connection © Other No.of Dryers Heating Appliances kw Security S ' No.of Devices or Equivalent No:of Water , No.of. No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent *Taecommturications 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.pf Rle mica!Work: (When required by municipal policy.) Work to Start: /4':�,- =- if { r Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVEIItAGE: 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 f4, BOND 0 OTHER © (Speci4r:) I retie,under the pains and penrtW es of perjury,that the information on dtis application is trite and complete. FIRM NAME: LIC.NO.: "tom 1.r Licensee �,i. ,, ..,l J, i r {..si :4 Signature' -— -_-' .---- LIC.N©.: 'j _ (lf applkablq,ettgr."exempt''in:the license nwnber lute.) Bus.TeL No.:' . c' �''zit" f, Address: -,� l ;4)"_.r- 0 id lie; Alt.TeL No.: �/i �` *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 Downer's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$