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Home My WebLink AboutBLDE-22-004643 . — Commonwealth of Official Use Only ie.n Massachusetts Permit No. BLDE-22-004643 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:2/22/2022 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) 5 NICHOLAS DR Owner or Tenant August Viekman Owner's Address 5 NICHOLAS DR, YARMOUTH PORT, MA 02675 Telephone No. 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 New Service gNo.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. 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 I No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Municipal Local ❑ P 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: OTHER: No.of Devices or Equivalent 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: Joseph W Silva Licensee: Joseph W Silva Signature (IfLICapplicable,enter"exempt"in the license number line.) Tel. NO.: 9147 Address:30 BOURNE HAY RD, SANDWICH MA 025632761 Bus.Tel.No.: *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. I PERMIT FEE: $50.00 Commonwealth o///la�lac.a sew Official Use Only I. *__- Z E. = _:. Permit No. s __-- ePartinental�ireSepvices _.>�,f= 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 EIectrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Z /41- Z 2-- City or Town of: it-fvt CI i(-4- To the Inspector of Wires: By this application the undersignedIgives notice of his or her intention to perform the electrical work described below. R Location(Street&Number) � IDS i L t 4 o( 5 �/Z-- Y, Po"-7 Owner or Tenant )US 7- V i c t.. M li- Telephone No. S Owner's Address .S.I M - F Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) jPurpose of Building �f Utility Authorization No. v rP �tpni7i9 L . c Existing Service Amps I Volts Overhead 0 Undgrd 10 g ❑ No.of Meters New Service Amps / Volts Overhead n Undgrdn _ No.of Meters 4 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: g{L,4,`Aff-L%g- c./Jc cru _ c d j Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transf ormeofrs Total KVAformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above El In- ❑ No.of Emergency Lighting grad. 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 AlertingDevices Tons No.of Waste Disposers Heat Pump Number]Tons KW No.of Self-Contained Totals:_ J Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connecti niecti o n 0 Other Co No.of Dryers Heating Appliances KW Security S stems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts 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: 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 covers a is in force,and has exhibited proof of same to the permit issuing office.__ CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:) eoill E.' -C . JS' C . I certify,under the pains and penalties ofperjury,that the information on this application it true and complete: FIRM NAME: .S/t.,V Ft F L,EG(t'LL.tC-.- LIC.NO.:4?/547 Licensee: i esr-fk 1,..1 £,L—fact— Signatur LIC.NO.:LZt4�7 (If applicable,enter "exempt"in the license number line. Bus.Tel.No.'s k` z-g*-9-' Address:<31) BOJ - i4 4 f .6'-'.19111rct M4 cz-5-4 S Alt.Tel.No.:--*,2 3C.-Li--'73l I *Per M.G.L.c. 147,s.57-61,security 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$