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HomeMy WebLinkAboutBLDE-23-003179 _; Commonwealth of official Use Only r Massachusetts 4,51 Permit No. BLDE-23-003179 `''°"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:12/8/2022 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 elect 'cal work described below. Location(Street&Number) 44 JOYCE ST ` `i C L" //1t Owner or Tenant Telephone No. Owner's Address -e0 .pq- B� Mtn T SAT .��g �7I-bIA1d6�l�Yt� 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 ❑ 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: Miscellaneous work per attached. 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: Siuns 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 ❑ 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: Craig S Little Licensee: Craig S Little Signature LIC.NO.: 24841 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 SYLVAN LN, FEEDING HILLS MA 010301707 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 , cpe -scifTelephone No. PERMIT FEE: $75.400 y 4x ( I( 2`, , 12Ii9) (4,, i2/itJ2Z ti 'JO Eii„..ho Caw ,," 5)-re t,- 4"r Commonwealth ' aeaarhreaalfe '•:it'- , cX Official Use Onl 1(_ •ptu tnunf o�� Serviced Permit No. �'Z i / li BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _�_ APPLICATION FOR PERMIT TO PERFORM Rev. r/all leave blankWp All work to be performed in accordance with the Massachusetts Electrical Code( EELECTRI4A.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) c,sz7 CMR l2.0o WORK City or Town of: YAR p ' '-emu Date: G g;h By this application the undersigned Ives notice of h®vher''T To Location(Street&Number) y`� intention to perforintthe ele ectrical wec tor of ork ay bed Owner or Tenant �� �� below, C/L G4 ,� � Owner's Address / ,/,d � Telephone No.YG LcI`� Is this permit in conjunction with ab=uiIdin �� Purpose of Building 8 permit? Yes Q No Q (Check Appropriate Box) Existing Service Utility Authorization No. Amps / Volts i�-� New v[ce ------- Overhead LJ Undgrd Amps / Volts ❑ Na.of Meters / Number of Feeders and AmpacIty1T Overhead Q Undgrd I Location and Nature of Proposed Electrical Work: ❑ No.of Meters - sec ci -___ U.�; No.of RecessedCom,/etiorr o the ollowin• C ��� �� r! Luminaires _ table m be waived by the hi Vector o Wires.No.of Luminaire Outlets No.of Ceil:Susp.(paddle)Fans `o.o No.of Hot Tubs Transformers ota ck ,'t` No.of Luminaires KVA SwimmingPool n- Generators KVA rove t No.of Receptacle Outlets rnd, ❑ mergency nd. Q 'o.o No.of Oil Burners Batte Units y No. Zo No,of Switches FIRE ALARMS of it' No.of Gas BurnersZones No.of Ranges `o,o i etec on an. No.of Mr Cond. ota fAleHn, Devices No.of Waste Disposers 'eat 'amp 'um er Tons No.of Alerting Devices No.of Dishwashers Totals: ' ~-._.......,on ►N ._s...._. `o.o e onta ne, Space/Area Heating KW Detection/Alertin Devices No,of Dryers Local 'un cipa `o,o "a er Heating Appliances ❑ Connection ❑ Other Heaters KW KW ecu ty ystems: `o,o No.of Devices or E r Si:ns °'° uivalent No.Ayd Heaters age Bathtubs Ballasts Data Wiring: No.of Motors No.of Devices or E r uivalent OTHER: Total HP c ecommun ca,ons " r ng: No.of Devices or E,uivalent Estimated Value of leetrieal Work: l ) `~ Attach add/clonal detail i ed,or as required by the Inspector Work to Start: P (When required b INSURANCE COVERAGE: Inspections to be requested in accordancey municipal policy.) e r of Wires. the licensee provides liability Inspections waived by the owner,no with MEC Rule 10 ,and upon un licenseed provi es that proof ofh coverage s in force,ein and has c mplete t for then"coverage of itssubelectrical work completion. Y ranee including`completed operation"covers CHECK ONE: INSURANCE coverage er substantial equivaletfe unless I certify,under I NSU pains and ©'tBOo D El OTHERproof ofsame to the permit issuing office. ❑ (Specify) FIRM NAME: /is Cary,1hat L the information on this a Licensee: (r / application is true and camp/ele. (If applicable,enr t:t, �'� Address: r .n he/terror nrrmbpr line.) Signature LIC.NO.:Zyg Vr„� *Per M. �tv 1`-11 4-1 G.L.c. 4 ,s.57-61,securityO':`_^ *Per M. 'S INSURANCE�,y work requires Departmentty" " Bt s. c.,,.....required b AIVER, I am aw hiLic of Public Safety e Lic 'ni •y law. BY my si are that the Licensee does nor erase: Owner/Agent signature below,I hereby have the liability. Lic N°' Signature y waive this requirement. fie insurance coverage I am the(check one 0 $ normally Telephone No. owner owner's a•ent. �'ERAHT FEE:$ 75