Loading...
HomeMy WebLinkAboutBLDE-23-005840 1p Commonwealth of Official Use Only iE,Piktlh' Massachusetts Permit No. BLDE-23-005840 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:4/20/2023 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) 9 ERIKS PATH Owner or Tenant NEVES CHARLES F TRS Telephone No. Owner's Address NEVES DONNA T, 9 ERIKS PATH, SOUTH YARMOUTH, MA 02664-1054 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for garage addition. 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 Initiating 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 Signs 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: DAVID R NICOLL Licensee: David R Nicoll Signature LIC.NO.: 37557 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 144 DRIFTWOOD LN, S YARMOUTH MA 026641038 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 iaQ-41..14 LE(2‘23 V --- `1( Z D//,// ��////q�/ � Official Use Only Com.monwea th o/ J//aseachu.eLL.+ �al On Only,, ryry,, _ Permit No. a_ t+ 1 - 1 .2)par1ntenl o/_lire ServIcal - _-�_; -_qM Occupancy and Fee Checked '.- BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYP A INFORMATION) Date: RE tot r City or Town of: MMApt,?'C' - 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)be 9 FR 1 k 5 (( M t't' =.1 C'a RL S V NE 5 Telephone No. Owner or Tenant P Owner's Address . Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service u Amps ldu/)YL' Volts Overhead Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity " r Location and Nature of Proposed Electrical Work: (A I,R6 & GE A /r2 d N 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 gtn . 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 Initiating Devices tal No.of Ranges No.of Air Cond. To No.of Alerting Devices ns No.of Waste Disposers Heat Pump.Nguiber_,__Tors. KW_---- No.of Self-Contained P° Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection No.of Dryers HeatingAppliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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 COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the Iicensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such coverage is in force,and has exhibi roof of same to the permit issuing office. CHECK ONE: INSURANCE iel BOND 0 OTHER 0 ( fy:) I certify, under the ins and penalties of perjury,that the information th' applicati ;is tr d complet FIRM N .9 epi i'D N IC°LL- t/" / I l IC.NO.: '3?5'57 E Licensee: Signature ( '1 LIC.NO.: (If applicable, enter"exempt"in the license 4umber line.) Bus.Tel.No.: 5© K.. 34'1-0,3t Address: WI fl(Lt Frwou,D L .5.11ARAti t n WI Alt.Tel.No.:5-0 -3 ,b`13i3(c u *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) 0 owner 0 owner's agent.