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HomeMy WebLinkAboutBLDE-22-006721 ;�`"o►" r_. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006721 *.mb ; ., 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:5/20/2022 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) 10 NAUHAUGHT RD Owner or Tenant HUSEBY JEANNE S Telephone No. Owner's Address 10 NAUHAUGHT ROAD, 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of solar PV system. No specs noted. 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 No.of Detection and Initiatine 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/Alertine 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: HeateSigns 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: Nathan A Ashe Licensee: Nathan A Ashe Signature LIC.NO.: 21136 (I/applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 166 Hunt Rd, Chelmsford MA 018243747 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Tel.No.: 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. IPERMIT FEE: $150.00 R E C E„,.,-_ ___ D Commonwealth oil MasdachudetfaI ficial Use Only MAYriti-----= - 2epartment o/. ire Serviced Permit No. ZZ— (/p C ._I_I_ _ _ , _ B•ARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked BUILDING DEPA TMENT [Rev. 1/07] (leave blank) BY - " ' '. &ATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code M .00 (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: / /���22 City or Town of: Y1 CoOLAN1 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) 1 0 JUG OVA Owner or Tenant '),eG(\6\P 'O./Se Owner's Address Sei as Telephone No. (J�_�'� 3�s� l A Ue,Is this permit in conjunction with a building permit? Yes 4T No Purpose of Building n � 1 ❑ (Check Appropriate Box) t 1 i ` Utility Authorization No. Existing Service 1 b Amps / Volts Overhead Z/ fl Undgrd g I I No.of Meters New Service Amps / Volts Overhead ❑ Undgrd E No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .1f3{3a I I I can & rc,�( 1C�-ovo ifs i c Qatar 9ymc . pc,.net �.�t K fi Li 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 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 f Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Valu off, f i, cal Work: �)01 C1 0 0 (When required by municipal policy.) Work to Start: (fxl?; 1tY 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 cove e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L7 BOND El OTHER El (Specify:) I certify, under t p 'ns and pen hies of perjury,that the information on this application is true and complete. O/� FIRM NAME: tx1 0Uo ' LIC.NO.: Licensee: Signature (If applicable enter "e empt'•i t e li_crse nuber 1' e,, .. ,✓� y� LIC.NO.: Address: C95, rt,es _5� 1_Sh 45i+lXlt iouti c)fl t till , O 7?(� Bus.Tel.No.: �� �� Per M.G.L. c. I' _.,� _. e Alt.Tel.No.: OWNER'S INS - .gi re u• es Dpartment of Public Safety"S"License: Lic. No. .f,. ° ' '`ht wai'e,that-the Licensee does not have the liability insurance coverage normally required by law. ,, .r:� r- � 1�» g �. 4n aye iy .this requirement. I am the(check one)El owner ❑owner's w ent. 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