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Home My WebLink AboutBLDE-22-004122 or r Commonwealth of Official Use Only ► Massachusetts Permit No. BLDE-22-004122 e� 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:1/25/2022 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) 3 ENTERPRISE RD NI Lt.-L-W ili A-12-L Owner or Tenant E Telephone No. Owner's Address 3 ENTERPRISE--RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. r Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters p New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters` Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement light in shop Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 1 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 Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Heating ace/Area No.of Dishwashers P KW Local ❑ Municipal Conne unici alConne Lion ❑ Other: HeatingAppliances KW Security Systems:* No.of Dryers PPances No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications 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 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: LIC.NO.: 56421 Licensee: Noah B Novick Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address: 16 Winslow Lane,Wareham MA 02571 *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. I Owner/Agent 'PERMIT FEE: $80.00 Signature Telephone No. C)L4 51 * RFCEIVED �j / �' y CO?71O ea °1/r/assachusa( Official Use Only 1 LJAN -fir aspartmant c7 n�7 Permit No. i� "C C Cam' BUILDING DE r .,„, r , , .*-__Ix_wi. E Occupancy and Fee Checked Y�;�e. I BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] (leave blank) ADDi rr%ATrr1►1 r-/-‘r, mr-e-,...— -- — . . ...... . , 2•11•11 I I v r amr Ui Y1 tLtl I KIUAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN MIK OR TYPE ALL INFOR161TION) Date: ; City or To of: YARMOUTH To the Inspector of Wires By this application the undersigned gives notice of his or her intention t perform the electrical work described below. Location (Street&Number) 4 1: . Y I ` ' f. -: Owner or Tenant '1 `,� `� O )l ''t A J � `' ',,i 0,4 Telephone No. Owner's Address / �" Is this permit in conjunction with a building permit? Yes No —/ 1 (Check Appropriate Box) Purpose of Building , .i v i , 11,:a � Utility Authorization No. Existing Service Amps / Volts Overhead _ Undgrd❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ` No. of Meters - Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 5hoI Completion of the following table may be waived by the Inspector o f Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total To. of Lumiaaire Outlets Transformers KVA No.of Hot Tubs Generators KVA J o. of Luminaires I Pool Above ❑ in- No.of Lmergency Laghang - Swimming _rnd grad. Batter?Units o. of Receptacle Outlets No.of Oil Burners -S FIRE ALARMS INo,of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices No. of Ranges !No_ of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Connection ❑ � Local❑ 7 No.of Dryers Heating Appliances KW Security Systems:* No. of Water No. °f No. of No.of Devices or Equivalent - HeatersSiKW4rts Ballasts Data Wiring: No.of Devices or Equivalent Telecommunications 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 of Electrical Work € ; j (When required by municipal policy.) Work to Start: I / i s l 5 l Z • Inspections to be requested in accordance with MEC Rule l0,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 Q BOND ❑ OTHER ❑ (Specify:) �L I certify, under the pains and penalties of perjury,that the information on this application is true and complete. J FIRM NAME: Licensee: ;, 1 4‘, 1- .', LIC.NO.: L,,C, Signature :7 7'- ;.% /7,= G (- If applicable, enter "exempt"in the license number fine.) LIC.NO.: ,-``� Address 1 Bus.Tel.No.: v L-v,,.'iL,1 C ..e.i L-^ to \n/'=;ram°,"r;.ii 1°' ' 6 t.-✓ t` i "Per M.G.L. c. 147, s.57-61,security work requires Department of Public Safety Alt.TeI.No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally rmally 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. 7 Owner/Agent I � I Signature Telephone No.c)L',' 3�tl i3 it. PERMIT FEE: $ ��--