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HomeMy WebLinkAboutBLDE-23-002507 ^ I-11 \a. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002507 � .. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.1/071 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:11/7/2022 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) 29 CAPT DORE RD Owner or Tenant SUE MURRY Telephone No. Owner's Address 29 CAPT DORE RD,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A ro r'la /ei Purpose of Building Utility Authorization No. h)• Existing Service Amps Volts Overhead 0 Undgrd 0 att6. f i New Service Amps Volts Overhead ❑ Undgrd El Number of Feeders and Ampacity ©4.‘.- .1.i.,Location and Nature of Proposed Electrical Work: Replacement furnaceCompletion of the following table may be wa � Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of V Transformers No.of Luminaire Outlets No.of Hot Tubs Generators A 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 1 No.of Detection and lratine Devices No.of Ranges No.of Air Cond. To of Alerting Devices No.of Waste Disposers Heat Pump Number Tons i 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 Egoivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Shins No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: TODD M ELLIS Licensee: Todd M Ellis Signature LIC.NO.: 21949 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 FOX HOLW,PLYMOUTH MA 023607737 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/Q l(/9/i/ (12,VC L ) RECEIVED w111 cor)601 „ } ) 1 (.en t nStwirift ,• n •�NOV ! �Q2� epsrfiwswt /_fi r Saivism Permit No.(�-3—2 s-c7 L_• �• aj Occupancy and Fee Checked `.�` L D 1 DIO LIRE PREVENTION REGULATIONS ev. lro7) (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: 111717 Z City or Town of: \Iar M1ntil1' 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) Z a C9 pi n Ye eel Owner or Tenant .St.)t: 140111 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No m (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1i3 I Ic TV r Darr Completion of the followin&tabk may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans Tf Tr anan KVAsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool 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 Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices 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 ElMunicipal El Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications quingg. Na of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 300 (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (X1 BOND 0 OTHER ❑ (Specify:) I cart(y,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: l II t Lne in LI ar LIC.NO.:2 IQyq A Licensee: 1'O& t II I'S Signature /�,y LIC.NO.: Of applicable, nw"exempt"in the license number line.) Bus.TeL No.:741 45 SO 2 Z Z Address: C;0 nei r S-,_e iv IC E..tethina1 11 0 A' AIL Tel.No.: 'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: 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 ❑owner's agent. Owner/Agent I PERMIT FEE:$ Signature Telephone No. 0 •