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HomeMy WebLinkAboutBLDE-23-001668 _ -. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 of y4,9_ (OFFICE USE ONLY) ^,i _) TOWN OF YARMOUTH By MATTACHEESE / Fee: $ "�"�"4 '� t9' r 7 PERMIT NO. afZ-;3----A (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 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&Numbed SO W l 1� --`` t tz` 7'C" Owner or Tenant SZA e'1(' 01 b Cli 1 1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? 3/Yes 71No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overheadn Undgrd 171 No. of Meters New Service Amps / Volts Overhead Undgrd 71 No. of Meters Number of Feeders and Ampacity { Location andNature of Proposed electrical W rk: (S 1 �� R j - - 1 Completion of the following table may be waived by the Inspector of Wires No. of Total No. of Recessed Fixtures No. of Ceil.-Susp.(Paddle)Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA Above en In- n No. of Emergency Lighting No. of Lighting Fixtures Swimming Pool grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Detection and No. of Switches No. of Gas Burners Initiating Devices Total No. of Alerting Devices No. of Ranges No. of Air Cond. Tons Heat Pump Number Tons KW___No. of Self-Contained No. of Waste Disposers Totals: ---+ —T- Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local [I Connection 71 Other Secutity Systems: No. of Dryers Heating Appliances KW No.of Devices or Equipvalent No.of Water No. of No. of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may be issued 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 e permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHERO (Specify:) (Expiration Date) Estimated Value of Elec ical�Qrk 1: n- �— (When required by municipal policy.) Work to Start: q r "!l// Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify,under theair}s.�nd penalty esl of erj ,that t fo ation on this application is true LIdCc NO lete1 ( 5�2 FIRM NAM �- lam'` J� � LIC.NO. 6'.�t-1© - Licensee: 1+ ) M dc1L L 4'� Signature Bus.Tel.No.: 'L� � 'y Address- applicable, enter``exem t�";n the li�Cgnse�n,� be ) S 61453Alt. Tel.No.: �}''�t'l0� OWNER'S T t 7`�'- �(,� 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 71 owner's agent.0 Owner/Agent Telephone No. Signature rMAI, (ld/001 Commonwealth of Official Use Only :, ,,t 1 Massachusetts Permit No. BLDE-23-001668 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:9/28/2022 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) 30 WIANNO RD Owner or Tenant RICK HUNNICUTT Telephone No. Owner's Address 30 WIANNO RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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, relocate washer/dryer, &electrical repairs. 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- ElNo.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 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 Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: 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 S eci I certify,under the pains andpenalties o (Specify:) fperjury,that the information on this application is true and complete. FIRM NAME: FRANCIS X MCPARTLAN Licensee: Francis X Mcpartlan Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 17552 Address: 19 RIDGEWOOD ROAD,BOX 817,SOUTH ORLEANS MA 02662 Bus.lt. Tel.No.::: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel. 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 El owner's agent.Owner/Agent Signature Telephone No. 'PERMIT FEE: $75.00 I —I its' , 1t(2 27 .(aktiax may) . 7 z 2