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HomeMy WebLinkAboutBLDE-23-001750 Commonwealth of Official Use Only i. Massachusetts Permit No. BLDE-23-001750 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:10/3/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfomi the electrical work described below. Location(Street&Number) 22 WIDGEON LN Owner or Tenant DAVID BEACHAMP Telephone No. Owner's Address 22 WIDGEON LN, WEST YARMOUTH, MA 02673 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: Replacement boiler 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 1 No.of Detection and Initiating 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: Heaters Siens 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: Joseph W Silva Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 Commonwealth. rr DD JJ C 1 c-ply ,i r C�om onwealth.a/Maddachrmet Official Use Only 7 17 i•--_-�9---ei c� Permit No. 41._z g_ice- I_ 2epartment of Sire Serviced ;, i£; g' Occupancy and Fee Checked 1 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 WINK OR TYPE ALL INFORMATION) Date: !' :j La` Z City or Town of: /d- `r(,'71J 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) ZZ, lid 1 P 1©►I L.---;,- Owner or Tenant 1-�/� v ID - 4 C/,/fin t 2 Telephone No. ' Owner's Address 5• E Is this permit in conjunction with a building permit? Yes U No [ (Check Appropriate Box) vPurpose of Building ✓ F't "`"g` Utility Authorization No. c Existing Service Amps / Volts Overhead ElUndgrd ElNo.of Meters VO New Service Amps / Volts Overhead f] Undgrd I 1 No.of Meters N Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i�C--- Cr1,,,/,.'(L 7 I C -L v c-s=.-' '.7 6.4)s -- Completion of the followin&table may be waived by the Inspector of Wires. No Tota `l KVA No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fansf 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 No.of Zones No.of Switches No.of Gas Burners No. In Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons .No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals:__ Detection/Alerting Devices Munical No.of Dishwashers Space/Area Heating KW Local❑ Connect ion ❑ Other Heating Appliances ICW Security Systems:* --___.——_ No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or Wiring: y g 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: `?- -y Z 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.�p/ CHECK ONE: INSURANCE (BOND El OTHER ❑ (Specify:) ecin 1ZE'ZC '' J1 § g"� I certify,under the pains and penalties ofperjury,that the information on this application is true and compere. FIRM NAME: S/t_A/fl £LdL rizac_-- LIC.NO.:A-?/'77 Licensee: asIloh t,,.i S ie-ice' Signatur LIC.NO.:£Zt4`ttri (If applicable,enter "exempt"in the license number line. Bus.TeL No. g"``fZ 0-94 E, Address:<3d , eh, - 14/0-1 205%4"J-t?r✓rci /1?t- OZ.- `6 S Alt.Tel.No.:. '0£r 3 . `/-`?31 *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 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.