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HomeMy WebLinkAboutBLDE-23-004042 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004042 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:1/23/2023 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) 26 ANASTASIA RD Owner or Tenant GALLAGHER AMY T Telephone No. Owner's Address GALLAGHER JAMES P, 210 MAIN ST,WINTHROP, MA 02152 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: Replacement furnace. 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 1 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 ❑ 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: Joseph W Silva Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 30 BOURNE HAY RD, SANDWICH MA 025632761 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 I(7 4Oq (1 1 ). L1Cl'irA l I, 0,7 Cotrunonweatth o//yladdaclzueet Official Use Only =i=5t tnent Permit No. =�%l_= e/nar o��ire Serviced `=1'f=g.1 Occupancy and Fee Checked „� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) 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: 1 ti - -S City or Town of: fir?-i n, r i# To the Inspector of Wires: By this application the undersignedgives notice of his or her intention to perform the electrical work described below. Location(Street&Number) %ZI, �Ir �n�'�ISin s it -, Owner or Tenant ,j r .i C 4.4 i 1 ii / Telephone No. Owner's Address �`�- E Is this permit in conjunction with a building permit? Yes U No E (Check Appropriate Box) tl Purpose of Building /rz=-'-7/A -_ v Utility Authorization No. AExisting Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters to J New Service Amps / Volts Overhead 1 1 Undgrd n No.of Meters Number of Feeders and Ampacity 1— Location and Nature of Proposed Electrical Work: --4`n,'.VLc"7 Xti=c.oc .,14(ti/7 ` ;' ri Completion of the followin•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. grad. Battery Units _ No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners I No.of-Detection and I Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number fTons KW INo.ofSelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW ;Local❑ Municipal Connection ❑ O�er No.of Dryers Heating Appliances KW eCNo.ofystems:* Devices or Equivalent No.of Water No.of No.of KW Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent No.Hydramassage 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: -.2,." "Z 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 covers e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 2--BOND 0 OTHER ❑ (Specify:) �i213'1/t1E/P—G ��S ;�'; I cert fy,under the pains and penalties ofperjury,that the information on this application is true and compere. FIRM NAME: /LA/A F L f 2IC... Qh S t� 'f'� Si afar LIC.NO.:4--?`77 Licensee: .:_.)t5st gn LIC.NO.:. ZtG 4-7 of applicable,enter "exempt"in the license number line. Address:( D Boo,--- - �1,9-st ,2r]' ,Q,JjrJrCd Bus.Tel.No.:�&—`f2-k''le) /1?9 02' �s Alt.Tel.No. U 3t /-'/3/I *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$