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HomeMy WebLinkAboutBLDE-23-000218 r ' - Commonwealth of Official Use Only t-, Massachusetts Permit No. BLDE 23 000218 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:7/13/2022 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) 84 HOMERS DOCK RD Owner or Tenant AlbertoMaitino Telephone No. Owner's Address 84 HOMERS DOCK RD, YARMOUTH PORT, MA 02675 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: In-ground pool. 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 Connection 0 Other: 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 ❑ (Specify:) 781- 3 �J i V L 3 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: John G Ashe Licensee: John G Ashe Signature LIC.NO.: 21752 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:68 LAKE ST, TEWKSBURY MA 018764472 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: $85.00 (tcram/ 61 -11 • ln; t Ae. ! a- _ .I , CaPrL`L `lit4 c.rbakXvOiN6 GR4''S Vim' 1 E C 1• D Ctnntowurea (o j maedachu Official Use Only • �n i47 �t L�s�arfinsat v`_ti,v Services• No. Z3—� j ' ..- BuARD OF FIRE PREVENTION REGULATIONS Occupancye . 1/07 and Fee Checked BUILDING DEf RTMENT 1/07] (leave blank) By-_______ —--•-=•_ TION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.0(1 (PLEASE PRATT IN INK OR TYPE ALL INFORMATION) Date: ?-13-.2aL City or Town of: l gipo,,,4t,,O To the Inspector of Wires: By this application the undersign d gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) g c/ t-f o m er hock RA Ow ner or Tenant AIber'L An4;+t, n ,, Telephone No. Owner's Address ,hL Is this permit in conjunction with a building permit? 1'es © No ❑ (Check Appropriate Box) Purpose of Building ees;wtct Utility Authorization No. Existing Service2p Amps ho /0'clo Volts Overhead ❑ Undgrd Q No.of Meters I New Service Amps d Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �h yt to .,4 Z ?eNN/ Completion of the following table mat•he waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of otal 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. To s No.of Alerting Devices 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❑ Municipalonnection 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Kit Heaters Data Wiring: Signs Ballasts 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 n5 o�f Electrical Work: �7, � (When required by municipal policy.) 1 'ork to Start: fi 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 certities that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I cernifj',under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Livewire electric Lic LIC.NO.: 21752a Licensee: John ashe Signature LIC.NO.: 21752a al applicable.enter "exempt-in the lit ense number line t Bus.Tel.N1-31 5-200$ Address: 68 lake st Tewksburyma 01876 TeL No.: *Per M.G.L.c. 147.s. 57-61.security work requires Departent of Public Safety"S"License: Mt.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. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ &s---0D0j