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Home My WebLink AboutBLDE-21-006026 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006026 v 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:4/20/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform a electrical work descr. ed below. Location(Street&Number) 14 ANGUS AVE A 01(= P,O n\ Owner or Tenant MAtoltrIEELEIFREI Telephone No. Owner's Address M Y, 213 GEfn Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) 60 j ,t1' Purpose of Building Utility Authorization No. c j5 . .7 - Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence Completion of the folq54,4tirAtip ,, e w 1. ,ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 5No.of _Transformers /� A <1 v No.of Luminaire Outlets No.of Hot Tubs Generators? A No.of Luminaires Swimming Pool Above ❑ In-d. ElNo.of Units ling grnd. gra Battery Unit Q No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS Noes No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 3 Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens 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: 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $180.00 (91/.._ (•66_)20.1,tiV--a,tetj b-7/2 ( ki 3 Cr?1( • t'/�/2 55 n/J aeaaA�` «6A� C enmw aith a`rr/addachiwatte Official Use Only -�, / c� [� Permit No. -7i� , " c—w ..;� ,1 2apartment of gip.:Jeraiced *"'I'l BOARD OF FIRE PREVENTION REGULATIONS Occupancy.10) and Fee Checked 'iat.ui" [Rev.1/07] (leave blank) IAPPLICATION FOR.PERMIT. TOCodeAll work to be performed in accordance with the Massachusetts Electrical PERFORM ELECTRICAL WORK V l (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 14—I(Q—Z CS! City or Town of: A 21v\G l`tH" To the Inspector of Wires: 0; By this application the undersigned Ives notice of his or her intention to perform the electrical work described below. v' J Location(Street&Number) 1`-( /A N G U S Owner or Tenant (V\/ra l i s C 1}-P o l'J Telephone No. 5c 6'7 7ic,178-I S Owner's Address ' 'Cr7 (-r 7 Sf �c.y 2✓11Gv Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) '73 Purpose of Building N•.V� CO NST 2 Jc- i 0 Ki Utility Authorization No. J Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters C) i New Service t C Q Amps up,2t{O Volts Overhead❑ Undgrd a No.of Meters j IV Number of Feeders and Ampacity , j()-,z yo Location and Nature of Proposed Electrical Work: N.e u.) C_0,1 S4 rt,c ti u ti Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trani 'Total Transformers �. KVA No.of Luminaire Outlets No.of Hot Tubs Generators C) KVA No.of Luminaires Swimming Pool Above ove In- ❑ No.of Emergency Lighting �rndk) Battery Units C t No.of Receptacle Outlets No.of Oil Burners Q FIRE ALARMS No.of Zones 3 No.of Switches No.of Gas Burners ' ( No.of Detection and " Initiating Devices No.of Ranges 1 No.of Air Cond. Tons Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number.Tons__KW_ No.of Self-Contained ( _ . Detection/Alertin Devices No.of Dishwashers ) Space/Area Heating KW Local Connection05� iP per No.of Dryers I Heating Appliances KW Security Devices or Equstems:* ivalent a No.of Water No.of No.of KW 7� Data Wiring: r\Heaters I Signs CJ Ballasts V No.of Dvices or Equivalent V No.Hydromassage Bathtubs 0No.of Motors j Total HP ,--, 'Telecommunications irm¢ 7 V No.of Devices or Equivalent U OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:1"]'"jC)O. — (When required by municipal policy.) Work to Start: t--7_0-2( 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 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: LIC.NO.: Licensee: Signature (If applicable,enter"exempt"in the license number line.) LIC.NO.: Address: Bus.Tel.No.* .Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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)❑owner owner's a ent. Owner/Agen •Signature Yti)Oi2,J C C' .\ Telephone No. 5-0E-77G(7 4 PERMIT FEE:$ 6 'c i