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HomeMy WebLinkAboutBLDE-23-002587 \l - ,'as Commonwealth of Official Use Only finkMassachusetts Permit No. BLDE-23-002587 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:11/9/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfomi the electrical work described below. Location(Street&Number) 519 STATION AVE Owner or Tenant DAVENPORT DEWITT P TRS Telephone No. Owner's Address 20 NORTH MAIN ST, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Access control, security, &camera system. 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 grnd. 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 2 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 7 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 Heating Appliances KW Security Systems:* 45 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 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: Joel E Zimmerman Licensee: Joel E Zimmerman Signature LIC.NO.: 1495 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 165 LITTLE BROOK DR, NEWINGTON CT 061115336 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: $115.00 i JP - 1f( 12:5 ,t RECEIVED NOV 0 9 2022e. aak6 4/Vuaaaehaaaw e,al Use Only `gam/j �'t (c�� Permit No. �(/�/- l �' {pa'.6"'d 4 Jim J."'""4 i -1;DING DE 'I Occupancy and Fee Checked �`, us} w ter. .,.:e- REVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK '1 All work to be perfemted in accordance with the Massachusetts Electrical Code(MEC)527 CMR l2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION)I Date: I I/7 ran a a City or Town of: 'ovrnad'14) To the Inspector of Wires: By this application the undersigned gives notice of his orher intention to perform the electrical work described below. Location(Street&Number) 5)9,Si-y+t 0 n Rik. 1 Owner or Tenant iev(�o(-4- I}�/1.�tuc->`" ,f Telephone No. 5 �',j I '3 I Q�S Owner's Address Qo l\LOt4h(V)glrl S w{' .S%%AYh YA'/h10UtJt r Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building SYMNttr,ts. Utility Authorization No. v Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters NI New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity l_ / Location and Nature of Proposed Electrical Work: Ty�S4cl/ /Ot,I ✓d I�f.s X Gray c. Ct CeeSS (o 4vo1 .' G Li Skm tam I',Cc etclacci-,el.(S#s 5.{skm. A.A. 17dove62)n A-5 F-0 5ts+h.-5, v} Completion of the followin&table m be waived by the inspector of Wires. v` No.off Total lb No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans Transformers KVA Z KVA ' C1 No.of Luminaire Outlets No.of Hot Tubs Generators Above In- No.of Emergency Lighting '4 No.of Luminaires Swimming Pool grad. ❑ gm ❑ Battery Units J No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones Z No.of Switches No.of Gas Burners No.InDetectionoi FInitiating Devices ILI No.of Ranges No.of Air Cond. Toonsl No.of Alerting Devices rs Heat Pump Number Tons KW No.of Self-Contained No.of Waste Dispose Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Loral 0 Comkipaln ®Other Dryers Heating Appliances KW Security Systems:* No.of D t'Y No.of Devices or Equivalent'6 No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent unications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Tel comm No of Devices or Equivalent OTHER: U PI rq\e @A141.0-Flue a z rvtit,5 r_S lam-9041r118s661,Corlthtayt t ca f tal Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:30/511,/1 (When required by municipal policy.) Work to Start: It(/)/a?a Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CVERAGE: 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 j] BOND 0 OTHER 0 (Specify:) 1 certify,under the pains and penalties of peijury,that the information on this application is true and complete. FIRM NAME: G 2(z) E ✓ld, LIC.NO.: Licensee: Joel (mm2YWu. Signature ,,,t._ LiC.NO.: I 95 "� (If applicable,enter"exempt'in he license',ti',timber line), Bus.Tel.No.' 860--61 54 Address: 65 Zt'hdoo� azd, WocKtY-iit (,-r O66E,-! Alt.TeLNo.: k6b-Nil-6Co1 °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 Signature Telephone No. PERMIT FEE:S 115.06 1 l t ._ . . .