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HomeMy WebLinkAboutBLDE-23-001406 Commonwealth of Official Use Only '.:- 141 Massachusetts Permit No. BLDE-23-001406 ° # 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:9/16/2022 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) 15 ALGONQUIN ST Owner or Tenant CORWEN KELLY A TRS Telephone No. Owner's Address C/O JOAN BURKE, 642 SW LAKE CHARLES CIR, PORT ST LUCIE, FL 34986 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: Install generator 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 1 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 Initiatine 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 ❑ 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: TIMOTHY W MCINTYRE Licensee: Timothy W Mcintyre Signature LIC.NO.: 31437 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 2428,TEATICKET MA 025362428 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: $75.00 i�� t(f CArjtE ?/ l z `4" ~. RECEIVED SEP 15 20?� a' T""y" -- ------- ammonuiaaGth o///taedachiudafie Official Use Only, y Permit No. L �. 13911 `4ILDING DEPARTXsarrfo1 !r �arucsdv e s t'. .v P '` ' BOARD OF FIRE PREVENTION REGULATIONS leave blank ` Occupancy and Fee Checked V 1 APPLICATION FOR PERMIT [Rev. 1/07] -----__, TO PERFORM ELECTRICAL W All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 WORK K _1,► (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) .."—r,4;�J City or Town of: YARMOUTH Date: 4t. /5— _ By this application the undersigned gives notice of his or her intention to perform the electrical work To the Inspector of Wires: Location(Street&Number) .' /4/` c described below. Owner or Tenant ; G��, e, —h h t Owner's Address c,�,i . Telephone No. ���` Is this permit in conjunction with a building permit? 3\( Purpose of Building Yes E] No [ (Check Appropriate Box) S ,, 'c/ Utility Authorization No. Existing Service �,� Amps P /40 / Z24<Volts New ervie Overhead❑ Undgrd r i S Amps / g No.of Meters Number of Feeders and Ampacity Volts Overhead[] Undgrd r g ❑ No.of Meters Location and Nature of Proposed Electrical Work: ',P1' Completion o the followin•fable m No.of Recessed Luminaires be waived b the Ins.ector o Wires. No.of Ceil:Susp.(Paddle)Fans 'o.o -` No.of Luminaire Outlets Transformers ota ``' No.of Hot Tubs KVA ,t No.of Luminaires Generators KVA Swimming Pool ,rnd.e ❑ n- 'o.o Units c �' No.of Receptacle Outlets nd• ❑ Bane Units y g mg No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners `o.lo 1 etec on an °`r No.of Ranges No.of Air Cond. ota If Alertingnitiatin Devices No.of Waste Disposers 'eat 'um Tons No.of Devices P 'um�er Totals: .................._._....... ons �• . ...••... o.o e - onta ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW No.of Dryers (� 'un c, Heating Appliances Local Connection 0 Other 'o•o "a er KW ecunty ystems: Heaters KW 'o•o `o o No.of Devices or E uivalent No.Ayd He assage Bathtubs Si,ns Ballasts Data Wiring: No.of MotorsNo.of Devices or E E.uivalent OTHER: Total HP e ecommun ca ons r, ring: No.of Devices or E,uivalent Value of Electrical Work: Attach additional detail ifdesired,or as required by the Inspector of Wires. Work Estimatedo Start: 5`f „ p (When required by municipal policy.) INSURANCE COVE` Ins ections to be requested in accordance with MEC Rule 10,the URANprovidesECOproof ofliability ess waived insurance the oner,noe and upon completion.issuea the licenseensed es that oh c,-o.;,ve,,r�s sin ce , ud has"completedcple proofperformance"cverag of itsel substantialbical work may nt. unless includingis operation"coverage or equivalent. The unCHECK ONE: INSURANCE E BOND same to the permit issuing office. I certify,under the pains and penalties o ❑ OTHER ❑ (Specify:) FIRM NAME: 1per�ury,that the information on this application is true and complete.Licensee: - c_../C An Signature r LIC.NO.: e- (If applicable,a ter"exempt"to the license r�mhnr 'ne.) Address: ' C� © �I LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requires De Bus.Tel.No. OWNER'S INSURANCE WAIVER: Alt.Tel.No.: partment of Public Safe y —re -------- OWNER'S by law. I am aware that the Licensee does not have the liability insurance coverage normally Owner/Agent By my signature below,I hereby waive this requirement. I am the(check one 0 Signatureowner � owner's a-exit. Telephone No. PERMIT FEE:$