HomeMy WebLinkAboutBLDE-23-006025 Commonwealth of Official Use Only
-. k Massachusetts Permit No. BLDE-23-006025
.,' 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:5/2/2023
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) 40 MAYFLOWER TERR
Owner or Tenant PETER LE Telephone No.
Owner's Address 40 MAYFLOWER TERR, SOUTH YARMOUTH, MA 02664
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 generator
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 1 KVA 21
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 0 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: John Minh Duy Vu
Licensee: John Minh Duy Vu Signature LIC.NO.: 14291
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:44 CLAYTON ST, DORCHESTER MA 021222708 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
Commonwealth of Massachusetts Official Use Only
I `,�k �Permit No. U S� (>
Department of Fire Services
Occupancy and Fee Checked
' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] (leave blank)
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: 04/25/2023
City or Town of: Yamouth 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) 40 Mayflower Terrace
Owner or Tenant Peter Le Telephone No. 6175921630
Owner's Address
Is this permit in conjunction with a building permit? Yes g No 7 (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service 200 Amps 120/ 240 Volts Overhead 17 I Undgrd 0 No. of Meters 1
New Service Amps / Volts Overhead Undgrd n No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install Generac 21000-Watt Standby Generator.
Completion of the following table may be waived by the Inspector of Wires.
v. No. of Recessed Fixtures No. of Ceil.-Susp.(Paddle) Fans No. of Total
Transformers KVA
C' No. of Lighting Outlets No. of Hot Tubs Generators 1 KVA 21
No. of Lighting Fixtures Swimming Pool Above In- No. of Emergency Lighting
grnd. grnd. I1 Battery Units
No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones I
No. of Switches No. of Gas Burners No. of Detection and
Initiating Devices
No. of Ranges No. of Air Cond. 'T['onsl No. of Alerting Devices
v.
Heat Pump Number Tons KW No. of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Locale Municipal nOther
Connection I I
No. of Dryers Heating Appliances KW Security Systems:
No.of Devices or Equivalent
No. of Water No.KW No. of No. of Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No. Hydromassage Bathtubs No.of Motors Total HP (Telecommunications Wiring:
v.
f No.of Devices or Equivalent
N.• OTHER:
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 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 171 l BOND n OTHER n(Specify:)
(Expiration Date)
Estimated Value of Electrical Work: -I 5 0 0 (When required by municipal policy.)
Work to Start: o9/2 j 12oz5 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
FIRM NAME: LIC. NO.:
Licensee: 7®h// 1/1/ Signature LIC. NO.:.0.291 5
(If applicable, enter "exempt"in the Ii nse number line.) Bus.Tel. No.:
Address: !fie ,S't 7Ose F .Sf - Dgfides f of - NA 0 2/2. Alt.Tel. No.: 71/ 30 g 9C51
OWNER'S I SURANCE 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. 1 am the(check one)EI owner nowner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $