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Home My WebLink AboutBLDE-23-001028 «-- Commonwealth of if• Official Use Only =. ' Massachusetts !11tN0 . BLDE-23-001028 ��"".. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.l/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) City or Town of: YARMOUTH Date:To 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) 75 PARTRIDGE VALLEY RD Owner or Tenant TUSHAR MISRA Owner's Address 75 PARTRIDGE VALLEY RD, WEST YARMOUTH, MA 02673 Telephone No. Is this permit in conjunction with a building permit? Purpose of Building Yes 0 No 0 (Check Appropriate Box) ServiceUtility Authorization No. Existing Amps xis Service Volts Overhead 0 Undgrd 0 No.of Meters Amps Volts Overhead ❑Number of Feeders and Ampacity Undgrd CI No.of Meters Location and Nature of Proposed Electrical Work: Miscellaneous work per attached. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 12 No.of Ceil:Susp.(Paddle)Fans No.of No.of Luminaire Outlets 5 Transformers Total No.of Hot Tubs KVA No.of Luminaires Generators KVA Swimming Pool Abovernd. ❑ In-n d. ❑ No.of Emergency Lighting :r Batter Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones 3 No.of Switches 16 No.of Gas Burners No.of Detection and 3 No.of Ranges No.of Air Cond. 1 Total Initiatin. Devices No.of Waste Disposers Heat Pump Number Tons No.of Alerting Devices 3 Totals: NE® KW No.Det of ctSelf-Contained No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local 0 Municipal 0 Other: No.of Dryers Heating Appliances Connection No.of Water KW Security Systems:* Heaters KW No.of No.of Devices or E i uivalent Si.ns No.of Ballasts Data Wiring: No.Hyd assage Bathtubs No.of Devices or E i uivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E i uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: (When required by municipal policy.) 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 I certify,under the pains and penalties o OTHER 0 (Specify:) FIRM NAME: fperJury,that the information on this application is true and complete. Licensee: Signature (If applicable,enter"exempt"in the license number line.) Tel. NO.: Address: Bus.Tel.No.: 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. Signature Telephone No. PERMIT FEE: $75.00 RECEIVED �,. AUG 5 2022 Af Ql -•--„..,,, ut nwtagh o/Vaoe�.c, Official Use Only = `ii1NG DEPARTME{Q7� G7 ¢�" artinttrlt 43. ��77 Permit No. J ( 0 ''/1111 .. _ CJt�} Jtrvtcse *' J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked „". [Rev. 1/07] (leave blank) �— 1.,,,.. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR.12.00 V (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH To the Inspector of Wires: a� 2 Z By this application the undersigned Ives notice of his or her intention to perform the electrt wo k descries below. c.." Location(Street&Number) 5 i F/2_l.2)6 V Owner or Tenant / O SNfy(2.. i Owner's Address Telephone No. 5-03 g'•-e R s-) R�Ti2)�66 ALiL rs ikMdF et MA d 26 3 Is this permit in conjunction with a building permit? Yes Purpose of Building No El (Check Appropriate Box) �- Utility A horization No. Existing Service AmpsOverhead L.Id� Undgrd '� N rvice g El No.of Meters —g'S-- Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampadty I g El No.of Meters `� Location and Nature of Proposed Electrical Work: Ri1/41 t5t{ 6•r eN[ e c i (af'S"%Ff R-L*t ivl , M \ vo t•L ' Completion o the ollowin table m be waived b the In ector o Wires. No.of Recessed Luminaires /2 No.of Ceil.-Susp.(Paddle)Fans °•° ota No,of Luminalre Outlets Transformers KVA 5 No.of Hot Tuba Generators KVA No,of Luminaires Swimming P°OI ove n- o.o met enc ;1 No.of Receptacleg r°d' ❑ d ❑ Batte Units y g ng Outlets �' No.of Oil Burners FIRE ALARMS No.of Zones 3 No.of Switches /l No.of Gas Burners o.oDetection an ill No.of Ranges Initiatin Devices 3 No.o�Air on ota No,of Alerting Devices No.of Waste Disposers Tons eat ump um er o.o e aria n Totals: ....__.._ ..__.. . .. ................ , * 5 Detection/ lertin Devices Space/Area Heating KW Local un c pa No.of Dishwashers No.of Dryers Heating Appliances KW ecu ty Csnnme8tion 0 r o.o a er o o No.of Devices or E ulvaleat rs KW °•° Data Wiring: Heate Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ors g OTHER: No.of Devices or E uivalent = zf Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:. ( ) Work to Start: OC/% 2��2Y (Whenrequired by municipal policy. 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER I certify,under the pains and penalties o 0 (Specify:) FIRM NAME: ry,that the Information on this application is true and complete. Licensee: LIC.NO.: (Ifapplicable,enter"exempt in the license number line,) Signature Address: LIC.NO.: *Per M.G.L.c. 147,s.57.. i,security work requires De Bus.Tel.No.: �`— OWNER'S INSURANCE WAIVER: lam aware that the Licensee does not have the liabilityLicense: insurancAlt.Tel.e No.: Department of Public Safety..S„License: required by law. ByLic.No. Owner/Agent my si lure below,I hereby waive this requirement, I am the(check one ranee coverage n� o— r`iy Signature owner ■ owner's a ent. Telephone No. $ S/� PER MIT FEE:$.