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HomeMy WebLinkAboutBLDE-22-006856 r ..� ..-• Commonwealth of Official Use Only Commonwealth %Ity Massachusetts Permit No. BLDE-22-006856 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:5/26/2022 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) 14 TROPHY LN Owner or Tenant HUNTER JUDITH A TR Telephone No. Owner's Address J A&Y HUNTER TRUST, 14 TROPHY LN, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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: Rewire heater 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 1 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: Licensee: Matthew Gordon Signature LIC.NO.: 55830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 Station Avenue, South Yarmouth Ma 02664 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: $50.00 Male i •a i RECEIVED , . F , s$k. MAY 5 211�4omnsonwaalth oi Maesachiueaiis Official Use Only C 1 '. :w iF� . t Permit No. C=-Z� chi; ILDING DEPART �0��w° eili�•�e - :'sAR©OrTIRE PREVENTION REGULATIONS [RevOc.1p/07cy and Fee Checked ' '' (leave blank) t.� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),,, 27 CMP. 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: % ` `L / .. 1 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned 'vet notice of his or her intention to perform the electrical work described below. Location(Street&Number) �" / p p 1/",V) ( A/ fl Owner or Tenant J:4C -1 rt-1 ti ,,` Vk-t'N Y^ Telephone No. _5 t j 04 Lie o Owner's Address 1 Is this permit in conjunction with a building permit? Yes ❑ No$ (Check Appropriate Box) Purpose of Building Utility Authorization No. '. ExistingService ❑ Undgrd❑ No.of Meters Amps_-_ / Volts O ead \�\� New Service Amps / Vo erhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r<a ti,,, t ce i q A � / 'c t®tt- s tyi e(� �J s* Completion of the following table may be waived by the Inspector of Wires. l,ja No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total (s/ Transformers KVA t No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4: No.of Luminaires SwimmingAbove In- 'No.of Emergency Lighting Pool grnd. ❑ grtitd. L. Battery Units :t No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones lz No.of Switches No.of Gas Burners No.of Detection and Initiating Devices II! No.of Ranges No.aAir Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: Detection/Alertln Devices No.of Dishwashers Space/Area Heating KW Local ElMonnec#unicipIonal El Other, C � 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 No.Hydromassage Bathtubs No.of Motors Total HP -Telecommunications Wiring: No.of Devices or Equivalent OTHER: 7_r0 Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: —5/2_3 '2--- 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 BOND 0 OTHER 0 (Specify:) I certify,under the pains and e a des of perjury,that the information on this application is true and complete. FIRM NAME: d/- t K/// �j o f a LIC.NO.: � �v bl Licensee: l �'1 e 0.,/ 6'-ref , Signature_,.! LIC.NO.: (If applicable,enter .'exempt in the license nu.mby line.) Bus.Tel.No.: .5 ai'r.6Gy 0 6 U Address: �, C) C c-7 4 i / ref- ''/1 N/ � AIL TeL No.: �� *Per M.G.L.c. 147,s.57-61,security work reqtfires 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:$ U'