The URL can be used to link to this page

Home My WebLink AboutBLDE-22-006270 Commonwealth of Official Use Only iii ,,, Massachusetts Permit No. BLDE-22-006270 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:5/2/2022 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 WOODBINE AVE Owner or Tenant Jorge Fuzer Telephone No. Owner's Address 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: New 100 A riser&meter main 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- ElNo.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 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 Signs 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 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 166 Hunt Rd, Chelmsford MA 018243747 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 e �j� J RE �+ _ Commonwealth o///'laddachaielfa Official Use Only E C ,,_=_:-_r/D irk= a ar ment ot�`ire Serviced Permit No. 7 APR -1= BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '�� [Rev. 1/07] (leave blank) 1 BUILDING DEPAP 'CATION FOR PERMIT TO PERFORM ELECTRICAL WORK By — — 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: `i - c -C City or Town of: YGrrrnj h To the Inspector of Wires: By this application the undersigned gives notice of his or her i tention to perform the electrical work described below. l Location(Street&Number) in dbbne Hie, Owner or Tenant ors-, FU , �r g83 � � Telephone No. 9a). 2 Owner's Address ` " 5 Q }vej Is this permit in conjunction with a bu9ilding permit? Yes frn No i��1� E (Check Appropriate Box) Purpose of BuildingL) Utility Authorization No. Existing Service Amps / /�/+� Volts Overhead Undgrd❑ No.of Meters New Service /O Amps JO /g40 Volts Overhead Undgrd I g � No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Le b3 in0n Pier and mP,ier main 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 Number i Tons I r KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal C ❑ Other Connection 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 f�`�I GOO Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Valu of ical Work: o (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 c�ove e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L.J BOND ❑ OTHER ❑ I certify,under t p ',is and pen hies of perjury,that the information onthis application is true and complete. FIRM NAME: !� � LIC.NO.: 1 Licensee: Signature (If applicable enter `e empt"i t ie licgnse nur, ber 1yre),_, l LIC.NO.: Address: 95 Nits _ >C+✓1G�'I_S� � �G#7t 0[i(�t°�tC��n �� i Bus.Tel No.:� `t3.��. *Per M.G.L. c. 147,s157-61,security work requires Department of Public Safety"S"License: LiAlt. e.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. I PERMIT FEE: $ I I