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Home My WebLink AboutBLDE-23-001888 k Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-001888 '''....0 .' 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:10/11/2022 City or Town of: YARMOUTH To the Inspector of Wires: 41,S By this application the undersigned gives notice of his or her intention to perform the electrical work described b o/ -�w.� [N/l/f� Location(Street&Number) 47 NICKERSON FARM WAY e(CX - So-) -4e 3 5 Owner or Tenant Daniel Christopoulos Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate B SVL 1 ro Purpose of Building Utility Authorization No. 10702516 tA t-t,�/ Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters s((a 2,3 New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence 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 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 ❑ 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. -� 5 ,Sly di CHECK ONE:INSURANCE ❑ BOND 0 OTHER 0 b ( pecif :)6( �& I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. ' L-* FIRM NAME: Dane M Thorogood Licensee: Dane M Thorogood Signature LIC.NO.: 53110 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 CLEVELAND ST, ENFIELD CT 060825308 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. ,-, I PERMIT FEE: $180.00 PI)t>/ I 'C, L' @e-0/112- i\i,tr 1-1(6-0 gvd)0611) /0/t/(z-24/ - R. of (If C6)titi2),1 Rive. i et vi,r tea. pm- it0463. i/A.1z3�. a zvtr ' ^ 7' Yst'szzee ' kiiC re r r«kguadz�rZ e f2 / Ye, ..-- , _.... •• , A oci. 07 2',t, lth 4 Madeaciumeth Official Use Only Permit No. .1i---- --k SW , i a -' 1 --i -- t4C;D E PA R ' ,'• ' 4 \ 34'0&mica, "- 'i 'BUILD _ Occupancy and Fee Checked -BY :.1:* ' e - PREVENTION REGULATIONS [key. 1/07] eavebIsnk) ilih. 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: City or Town oh ' , , - 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) , Owner or Tenant - Telephone No. - , Owner's Address Is this permit in conjunction with a building permit? Yes 0 No El (Check Appropriate Box) Purpose of Building ' Utility Authorization No. Existing Service Amps I Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps 1 I Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: ..,. Completion of the followingstabk may be waived by the Inspector of Wires. -,i .:. No.of Recessed Luminaires No.of CeB.-Ssisp.(Paddle)Fans No.of Total Transformers KVA _ •' No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Lundnaires Pool Above ri In- r-i No.or kmergeney Lightlig Swimming and. I—, and. 1—J llattery_Unitz No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ' - No.of Switches No.of Gas Burners -Na of Detection and Initiating Devices Todd No.of Ranges No.of Air Cond. Tons .of Alerting Devices Vont Pump Number TTops KW 'No.of Self-Contained No.of Waste Disposers Totals: --- Deteedon/Alertinn Devices No.of Dishwashers Space/Area Heating KW Local CI nu= 0 Other No.of Dryers Heating Appliances KW Secuofrity Systeicms:* No. Deves or Univalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Ea"it;i7Zent OTHER: Attach additional detail(desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 13 2-- lc- (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 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 ofperjony,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: , Signature LIC.NO.: (If applicable,enter"creittpt"in the license minber line.) Bus.TeL No.: Address: Alt.TeL No.: _ - :, • *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S 1 ',URANCE ' AIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. : ,, •.1 , below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent Owner/Agent - r -..- 1 Signature Telephone No. re--1-4=la) ?:(117,7, PERMIT FEE:$ --- C -- ThiNz, (GFe,t) I:LLB A3At8 (Gred) ji21.41,j2,5