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HomeMy WebLinkAboutBLDE-23-003580 • - or Commonwealth of Official Use Only �_i� ` Massachusetts Permit No. BLDE-23-003580 '��%�7 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:12/31/2022 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) 135 SOUTH SHORE DR UNIT 24 Owner or Tenant GILL JOHN P(LIFE EST) Telephone No. Owner's Address GILL NORAH E(LIFE EST),14 HORIZON DR,SARATOGA SPRINGS,NY 12866 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check/[ppry Purpose of Building Utility Authorization No Existing Service Amps Volts Overhead 0 Undgrd ❑ (�pvo New Service Amps Volts Overhead 0 Undgrd 0 oo a /lk Number of Feeders and Ampacity _ G/r///� r�', Location and Nature of Proposed Electrical Work: Install Circuit for range Completion of the following table may be waiv d� tor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of �tal Transformers A No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. 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 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tuns 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 Ill' Telecommunications Wiring: No.of Devices or Univalent OTHER: n Attach additional detail iif desired. L ISI�T I j4 q' 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 comple (N S INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unit ' proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifiet V' l A,'/� ,(�ss IQ,(e, is in force,and has exhibited proof of same to the permit issuing office. V CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) 3 ( t'7 /certify,under the pains and penalties of perjury,that the information on this application is true and complete. `I% FIRM NAME: BENJAMIN NARDI Licensee: Benjamin Nardi Signature LIC (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 GREAT WIND DR,PLYMOUTH MA 023602778 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 wri( RECEIVED C',edte t DEC 14 22 qq,� Comnwnwaatth el Maddachuea(fe Official Use Only Q BUILDING '�_ ":�r`'`7� T cal AY- / n Permit No. re2z 3s €JO By •� ;e•_.. t nt or giti Serviced e `.:.I,I .�4 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CMR1, 2. 'l2.00 ^ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: qy C / ' w ` City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intentio to perform the electrical work described below. Location(Street&Number) /)`5 A; -if?�;(; r. i -t 2. 3 Owner or Tenant J �' 1 11 ET I 1 / Telephone No. / 7 67 3 ? 1/`( Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building ( S ) 4--(67., a Utility Authorization No. Existing Service /( i Amps (Z' /2JC)Volts Overhead Undgrd I ©� g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: ,,(.I(,,,/ C 1 r( jai ! ,- -rI ez 7/, L— No v) Completion of the followink table may be waived by the Inspector of Wires, i No.of Recessed Luminaires No.of Cell.-Stop.(Paddle)Fans No.of 7 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 Detection and 4. _ No.of Gas BurnersInitiating Devices I U No.of Ranges No.of Air Cond. Ton 1 No.of Alerting Devices No.of Waste Disposers Heat Pump Number :Tons KW 'No.of Self-Contained Totals: ' Detectlon/Alertin Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters - KW No.of No.of 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 of Electrical Work: (When required by municipal policy.) Work to Start: /.;- -( `/ 2--2 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 covyrage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE it BOND 0 OTHER 0 (Specify:) I certify,under the pains an, , nalties ofperjury,that the information on this plication is true and complete. FIRM NAME: LIC.NO.: _ Licensee: ' ,l1 ,X,/c C' Signature / G- ( C LIC.NO.: �5D`) 3S (If applicable t "exempt"'n the,(icense numbe line.) ( T - 1-- V Address: C, t�r'X J/ .5 e l A,�.� I LV1 '� V i 2 Bus.Tel.No.•l /; 5 r Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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. I am the(check one)❑owner Q owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 57)— Ck, - (DCp