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HomeMy WebLinkAboutBLDE-22-005484 • of_, Commonwealth of Official Use Only It Massachusetts Permit No. BLDE 22-005484 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:3/30/2022 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) 216 WINSLOW GRAY RD Owner or Tenant Joel Dorce Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. i' Existing Service Amps Volts Overhead 0 Undgrd 0 #ers New Service Amps Volts Overhead ElUndgrd ❑ Nos Number of Feeders and Ampacity 0 Location and Nature of Proposed Electrical Work: Install generator n Completion of the following table may 14., t e r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of otal Transformers 5r VA No.of Luminaire Outlets No.of Hot Tubs Generators 1 / Q VA 14 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Liigg9 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofper/ruy,that the information on this application is true and complete. FIRM NAME: Licensee: Steve Wilson Signature LIC.NO.: 22634 (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.: - Address: 193 Holyoke Street, Ludlow MA 01056 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: $50.00 Commonwealth o/2/amachuietto Official Use Only �b c�77 C� Permit No. im1 aLJePartment oI }ere ervicee •__� ryry�� Occupancy and Fee Checked • =% BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 INFORMATION) Date: March 23, 2022 City or Town of: West 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)216 Winslow Gray Road Owner or Tenant Joel Dorce Telephone No. 774-606-5072 U) °; Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. G o Existing Service Amps / Volts Overhead Ti Undgrd❑ No.of Meters New Service Amps / Volts Overhead Ti Undgrd ❑ No.of Meters E Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 14kw Generator Completion of the followingtable may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans T of Tr No KVAansformers 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. Initiating of Detectionand Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal L. Other Connection No.of Dryers Heating Appliances hy�; SecNoto Systems:* Devi es or Equivalent No.of Water KW No.of No.of 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: 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 ❑x BOND El OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the informati 1 , tl 's applic\ in is true and complete. FIRM NAME: JSN Services, Inc. LIC.NO.: 939458 Licensee: Steve Wilson Signature 4r ,S LIC.NO.: 22634A (If applicable,enter "exempt"in the license number line.) ;us.Tel.No.: 413-583-2227 Address: 193 Holyoke Street Ludlow, MA 01056 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. SS-002597 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 I PERMIT FEE: $50.00 Signature Telephone No. 1