HomeMy WebLinkAboutBLDE-23-004635 Commonwealth of Official Use Only
ft-. , Massachusetts Permit No. BLDE-23-004635
• 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 Codc (MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:2/22/2023
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) 18 CHANNEL POINT DR
Owner or Tenant RAJ JAYASHANKUR Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No.of ters
Number of Feeders and Ampacity I \
Location and Nature of Proposed Electrical Work: Rewire garage (Water damage)&rework pane�z 4
P
Completion oft •.•7o a by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Total
Tra O KVA
No.of Luminaire Outlets No.of Hot Tubs Generators O KVA
No.of Luminaires Swimming Pool Above ❑ in- ❑ No.of Emergenc
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zi U
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 ❑ 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 ❑ BOND 0 OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: THOMAS E CUNNINGHAM
Licensee: Thomas E Cunningham Signature LIC.NO.: 8410
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: PO Box 48, Leicester MA 015240048 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
1�- 3/q2,, W ( l-'!5 L/4i)
Commonwealth of Massachusetts Official Us Only
+*_ , Permit No.: e?.,3 — (v,_ gi f De artment o Fire Services Occupancy a ee Checked:
`' — 7_= BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/2023]
vt . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
City or Town of: YARMOUTH • Date: Oc1/42 //J3'
To the Inspector of Wires: By this ap ication, !,�the undersigned undersigned giv notices of his or her intention to perform the electrical work described below.
Location (Street& Nu er): > e/M Unit No.:
Owner or Tenant: ) 5 i II Email:
Owner's Address: 5,01e. ✓i< /9-13'LA✓ Phone No.:
Is this permit in conjunction with a building permit? (Check appropriate box) Yes ❑ No [Permit No.:
Purpose of Building: Utility Authorization No.:
Existing Service: Amps / Volts Overhead 0 Underground ❑ No. of Meters:
. ' New Service: Amps / Volts Overhead ❑ Underground ❑ No. of Meters:
Description of Proposed Electrical Installation: /e Vi24C- t- LZr,7/C/Yt Y2/M24-ZZ.-
4%—ttijitle7 adit 49-6,1-?- (it/nint P6 vi)-6 6-5-)
Completion of the following table may be waived by the Inspector of Wires.
No. of Receptable Outlets: No. of Switches: Generator KW Rating: Type:
No. Luminaires: No. of Recessed Luminaires: No. Wind Generators: Wind KW Rating:
No. Appliances: KW: No. Water Heaters: : No. T�sformers: Total KVA:
Space Heating KW: Heating Equipment KW: N94Motors: Total HP: Total KW:
No. Heat Pumps: Total KW: Total Tons: Fire Alarm System ❑ No. of Devices:
Swimming Pool: In-Grnd. ❑ Above-Grnd. ❑ Hot-Tub 0 No. of Self-Contained Detection/Alerting Devices:
No. Oil Burners: No. Gas Burners: Video System ❑ No. of Devices:
No. Air Conditioners: Total Tons: Telecom System ❑ No. of Outlets:
No. Energy Storage Systems: KWH Storage Rating: Security System ❑ No. of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No. of Electric Vehicle Supply Equipment:
No. of Modules: Roof-Mount ❑ Ground-Mount ❑ Level 1 0 Level 2 0 Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 07,"VC . — (When required by municipal policy)
Date Work to Start:f ,21,, 67-7 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
FIRM NAME: 41, i (., / 7i, 1161Z1 l a1 A-1 C-1 ❑ LIC. No.:
Master/Systems Licensee: a��_,,cc .(�
Y // G-'�/tom LIC. No.:�'���
Journeyman Licensee: 1"�Yee LIC. No.:`' -' 0 t/
Security System Business requires a Division of Occupational Licensure"S" LIC. S-LIC. No.:
Address:
Email: Telephone No.:
I certify, under the pains and penalties of perjury, that the information on this application is true and complete.
• Licensee: ,/?di ,1/i
��`� !.f`d-/'11--* Print Name: % Pil A/�,�lhiQ./6,711.4 Cell. No.: _52,7""se-'0.3 e491
INSURANCE COVERAGE: Unless waived by the owner, no permit for th:, performance of electrical work may issue unless the licensee
provides proof of liability including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage
is in force and has exhibited proof of same the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ Specify:
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 0
Owner/Agent: Tel. No.:
Signature: Email.:
7s,oD
75-6?r