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HomeMy WebLinkAboutBLDE-23-002523 Commonwealth of �" ° Official Use Only 1-: kt Massachusetts Permit No. BLDE-23-002523 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:11/8/2022 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) 7 RANDOLPH RD Owner or Tenant ALEX BECRELIS Owner's Address 7 RANDOLPH RD, YARMOUTH PORT, MA 02675 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 Number of Feeders and Ampacity gNo.of Meters Location and Nature of Proposed Electrical Work: Replacement HVAC. 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 ❑ grnd. El Battery of Emergency Lighting Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting 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 Signs Data Wiring: 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 LIC(If applicable,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 ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$50.00 I ,,V triet-----2-- -e 64:(KA44 N ii4 _cif6& cA ,per /� pp!! s� ��-7 _L\ l.ommonwealth a/Mamaclzulett4 Official Use �Only V_o cc�� Permit No. f tiel- 1 Thepartment al_7ire�erviced rf _hL=.g Occupancy and Fee Checked ' fir„,. 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: //-/-Z'Z City or Town of: i 4°'-'71t' 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) 'I IJ p L p/.L 7-9 Sk Owner or Tenant AG-c, Z�c'. c4S Telephone No. J Owner's Address SP/'?e Is this permit in conjunction with a building permit? Yes U No ©---- (Check Appropriate Box) Purpose rpose of Building �S t o f-4 7iq t_- Utility Authorization No. c Existing Service Amps I Volts Overhead 0 Undgrd C No.of Meters IA J New Service Amps / Volts Overhead n Undgrd n No.of Meters N Number of Feeders and Ampacity l Location and Nature of Proposed Electrical Work: j Completion of the following table may be waived by the Inspector of Wires. s No.of 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 Swimming Pool Above ❑ In- D No.of Emergency Lighting grad. grnd. Battery Units s 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 1 No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons_�KW No.of Self-Contained P Totals: ,Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Connection ❑ Other J No.of Dryers Heating Appliances KW Security Systems:* 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 I 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: / -"1-Z 2— 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 [BOND ❑ OTHER ❑ (Specify:) 6.9,4l/y/f�C� -.ls i�/ "P I comfy,under the pains and penalties of pedury,that the information on this application is true and compere. FIRM NAME: ,/LA/4 F 41 G(12.K_. LIC.NO.:,?/477 Licensee: --�bSG�'i1 t� S%c ✓ " Signatur \ LIC.NO.: Z/G{' (If applicable,enter"exempt"in the license number line. Bus.TeL No. k`'KZ-f.` 4' Address:,,9 , Dv2 - 14A-1 ,6'J9"4c- /j'l 4 617-5 4-S Alt.Tel.No. G 34=. '73 t, *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: $