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HomeMy WebLinkAboutBLDE-22-005809 or : Commonwealth of Official Use Only E•�, Massachusetts Permit No. BLDE-22-005809 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/12/2022 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) 25 CONSTANCE AVE Owner or Tenant LACEY JEFFREY Telephone No. Owner's Address 133 I ST APT 2, BOSTON, MA 02127 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace panel, boiler, &permit illegal room in basement. 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 grad. grnd. Battery Units No.of Receptacle Outlets 8 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 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: STANLEY D ANDREWS Licensee: Stanley D Andrews Signature LIC.NO.: 15248 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:201 HEAD OF THE BAY RD, BUZZARDS BAY MA 025325640 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: $260.00 tNri,0 ' ( (13V- (t - its1� �L a, Ij) ►1/t i 2- try @ �.A Commonwsatth ol�//taaaachuastia cial Use �-, t i• ,t Permit No.c� c'7 ZZ - '7 .. epartnu<ni of irs�eruicso +, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) «k,h APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(Iv C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '///) /2'")- City or Town of: ,,r-�.c L-1-1-- To the Inspector of Wires: ,- By this application the undersigned giv�es notice of his or her intention to perform the electrical work described below. L. Location(Street&Number) ca.c C©n-5j,,, Owner or Tenant Telephone No. CD Owner's Address 4 Is this permit in conjunction with a building permit? Yes Ei No C (Check Appropriate Box) N Purpose of Building\);„,fr.t,11,,,,.b Utility Authorization No. Existing Service 1 t't, Amps j ?O7/ 2'Ll Volts Overhead Undgrd_ No.of Meters / New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity ..0 Location and Nature of Proposed Electrical Work: ze P la,r' Jh..,.1 C>!K/,t r) W.r e l,+'u Zell e r) P-e.L,,r r' P4..vi ' i''- t. le- .ti,r4 i p i.,.c r' e,,,41e f s cc'r b d v.1.el i-y Completion of the fallowin&table may be waived by the ln. ector of Wires. Total Lb_ No.of Recessed Luminaires No.of Cell:Sua (Paddle)Fans No.oof KVA �, p• ,Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool 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 I Initiating Devices 1U No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained I Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Locunicipal al❑ Monnen ❑ Other No.of Dryers I Heating Appliances KW `Securhy Systems: * 1'Y No.of Devices or Equivalent No.of Water , No.of No.ofK Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: No.H Y g 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: y fdy 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 [RI. 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: 8✓z7-rd1S" ,,,1 Eieckrdr LIC.NO.: /'5 '/P9 Licensee:Ski,L,.z .I J. A y., r t,.3°y Signature,`Z� �� "I, ls-�'� LIC.NO.: (If applicable,enter"empt'"i the license number line.) Bus.Tel.No.:.� -75' I"t) Address: 7) ec.(../el )-►^{ ,-f R ( bc.:2,;L,.cis' A v I41L Jc3� Alt.TeLNo.:jdd-4yS"-" /y22 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 Ej owner's agent. Owner/Agent �`�/' Signature Telephone No. PERMIT FEE:$Dili6i