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HomeMy WebLinkAboutBLDE-23-001948 - a= `� ;1 Commonwealth of Official Use Only klt` !1� Massachusetts Permit No. BLDE-23-001948 "" 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:10/12/2022 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) 484 WILLOW ST Owner or Tenant NSTAR Telephone No. Owner's Address P 0 BOX 270, HARTFORD, CT 06104 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: Remodel CEO's office area. 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 19 Swimming Pool Above ❑ In- 0 No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 25 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 13 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total 2 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: 1 2 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Euuivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Euuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Euuivalent 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: David W Noon Licensee: David W Noon Signature LIC.NO.: 13878 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 EDGEWATER DR, NEEDHAM MA 024922709 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/A e Signature' \}U(,4 L 11 �� Telephone No. PERMIT E: $100.00 2 „.. ►61, 61w _ a S.-QLIE CtztliU Z 4tX LY t l((7( crt t_ izl (( 72 (. RECEIVE © QQ// // • I 2022 o n.wealth o/Maddachudet Official Use Only evil- / OCT 12 Permit No. v 2�—A ` C_till= , e rtmenl o��ire�erviced ` '— " Occupancy and Fee Checked 'tLDBOAR IME PREVENTION REGULATIONS [Rev. 1/07 'b,,,,:,, (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 INFO TION) Date: I 0 µ- /I- 2-Z City or Town of: ym.. wvt, 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) Li Pt( bit Colo 31 Owner or Tenant Eti Q(0.)i)jLJ* Telephone No. Owner's Address SA4K.it Is this permit in conjunction with a build' g permit? Yes a No E (Check Appropriate Box) Purpose of Building U 411 L Q:J hL Utility Authorization No. ExistingService I it -' Amps )?/ O Volts Overhead Und rd No.of Meters P � � ❑ g New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location�and Nature of Proposed Electrical Work: f AM-tt ( ,-f 7 T[_� C a as 40 IA)ac C{ C t.a�Pt l l ru .41 t Completion of the following table may be witived by Ahe Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires l Swimming Pool Above ❑ In- ❑ No.of Emergency Lightinggrnd. grnd. Battery Units No.of Receptacle Outlets d S No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches , No.of Gas Burners No.of Detection and Initiating Devices Totallo.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KIV No.of Self-Contained p Totals: I ..) Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local DiConnectioMunicipaln ❑ Other No.of Dryers Heating Appliances KW ecurity Systems: rY * No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: QD Heaters Signs Ballasts No.of Devices or Equivalent ^dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: ( J No.H Y g No.of Devices or Equivalent 1 OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: Ill/IVV (When required by municipal policy.) Work to Start: (OI If I a), Inspections to be requested in accordance with MEC Rule 10,and upon completion. l 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 J BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete.FIRM NAME: SI- ItA %SNAP l.rr k) Ay/ A16 LIC. NO.: 31 O Ai Licensee: jtjahwN. Signature V-z........ LIC.NO.: (If applicable,enter "exe t"in the license number ne.) �/�� Bus.Tel. No.• fog 0 0 Address: r�-0 ��+12,t k 4J LLr 01A41k. fA4 02 6 Alt.Tel.No.: l., *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: $