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HomeMy WebLinkAboutBLDE-23-003362 -' Commonwealth of Official Use Only . `w Permit No. BLDE-23-003362 ', ,;fit Massachusetts . 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:12/16/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfor the electrical w`rk escribeedbelelow. Location(Street&Number) 29 LUCERNE DR U l -l, 6t- 11 Owner or Tenant Telephone No. Owner's Address 29 LUCERNE ST,YARMOUTH PORT, MA 02675-2120 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: Replace service. 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 Above In No.of Emergency Lighting No.of Luminaires 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 No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices Local ❑ Municipal 0 Other: No.of Dishwashers Space/Area Heating KW Connection Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or No. 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: hnspection 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 penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOHN R HASSAY LTC.NO.: 38186 Licensee: John R Hassay Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:28 THAYER ST, SOUTH DENNIS MA 026603717 *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 I PERMIT FEE: $50.00 Signature Telephone No. gComnwnwsa/h o/Maadachwelie Official Use Only :A��-.�. /Jsparintani o� }irs Jarvicsd Permit No. G 23 j(r •?!�` Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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:)mac— 16, Z '2-2 _. 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) /2___c? L--__(-_,G -t,,i,1 -e U)i/tv. Owner or Tenant j✓, I ik-%10v--S Telephone No. ''---;-0 c.) --, 29 Z .r0 6' 3 Owner's Address <'t. k. Is this permit in conjuns I,with a byilidding permit? Yes ❑ No (Check Appropriate Box) Purpose of Building 1� t✓_.. L `� Utility Authorization No. Existing Service I b0 Amps 7,0/2 QVots Overhead Undgrd1 g E No.of Meters New Service Amps / Volts Overhead❑ Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Icc, l l�,t' /',�'e c,(.../se �44 l t ,M .D/S(JziriF�:7 Iry 5'KS -u�/ d— P�th rfu Conrl pletion of the following table muy be waived by the Inspector of Wires, Zit No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total ofTransformers KVA 'Zt No.of Luminaire Outlets No.of Hot Tubs Generators KVA Wit;` No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. grnd. ❑ Battery Units ;! No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Y No.of Switches No.of Gas Burners No.ofbetection and Initiating Devices 111 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 ❑ Other Connection No.of Dryers Heating Appliances KWSecurity Systems: No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or E uivalent 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 World �' (When required by municipal policy.) Work to Start: -pc` 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 covera,�.� / e 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 p nalties of perjury,that the information on this application is true and complete. FIRM NAME: a �,ll LIC.NO.: Licensee: J •Ze '5 e" Signatu ( C (If applicable,env"esem in the license nu, ,r line.) Bus.Tel.No. Sc)P Z Z( ©s Y 7 Address: • . r. it Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,s curity 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 ❑owner's agent. Owner/Agent Signature Telephone No, PERMIT FEE:$