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HomeMy WebLinkAboutBLDE-23-004456 V Commonwealth of Offi V Massachusetts Permit No. BLDE-23-004456cial Use Only BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked lRev.1/071 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:2/13/2023 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 de ribed below. Alcation(Street&Number) 56 NORTH RD S(e_Jr4 Q t.,R N b('' Owner or Tenant bkikeleiRggellITOS44E.R€1 Telephone No. Owner's Address MB7RRI,56 NORTH RD,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A rpgriate IN) Purpose of Building Utility Authorization No. 1 11 ff]3!7L 4 Z3 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 .of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.arrvfeters (JC.i Number of Feeders and Ampacity eAp`'N' Location and Nature of Proposed Electrical Work: Upgrade&relocation of service. 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 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 ❑ 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 Euuivalent 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: NICHOLAS J MCLEAN. Licensee: NICHOLAS J MCLEAN Signature LIC.NO.: 53676 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:3 HAMPTON CIR,HULL MA 02045 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:50tabLE t 11W3 t • //�� DD// // Official Use Only C.ommonwea�th 0/ �a��achu�ette . ' --al , ° — I c� �7 Permit No. t-----2-3 -- 4 S-Lo =ami- .2epartment o/.}ire Services -= :' 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 ( EC),,527 CMR 12.00 (PLEASE PRINT IN INK OR P ALL INFORMATION) Date: 5City or Town of: (JC(` u-o" To the Inspecto of Wires: By this application the undersigned gives notice of his or her inte tion to perform the electrical work described below. Location (Street & Number) 5Q Al 0(4, le ci , Owner or Tenant E S-- e,oxo Leo/laxof . Telephone No. 77q- 3(, Owner's Address Is this permit in conjunctionpermit? Yes ❑ No I wit a building g (Check Appropriate Box) Purpose of Building rce5t e /1'} 0A Utility Authorization No. I j 1-'1 ' S' Existing Service I O Amps / (9 Volts Overhead Undgrd No. of Meters / New Service GIOC Amps (a' / Volts Overhead E1 Undgrd ' No. of Meters Number of Feeders and Ampacity �,, Location and Nature of Proposed Electrical Work: �0 0 �C)C9 J yc, Cie fog ("1 , t/A O Jr_;`vf ;V) c k c e1ck c \ ko (Z,00k `- L COAC 4 1,,0v£. & w C 'it( Completion ofthe ollowt table maybe waived by the Inspector Wires. No. ofP f g Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans KVA 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 Initiating 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 ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* ry No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Beaters ,-- Signs Ballasts No. a Devices or Equivalent No. H dromassa a Bathtubs No. of Motors Total HP Telecommunications Wiring: y g No. of Devices or Equivalent OTHER: • r Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4 QA715 (When required by municipal policy.) Work to Start: dS Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO E GE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liabili insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cov age is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pai s curl pena Les of perjury, thatihe information on this application is true and complete. s FIRM NAME: tL 9S . Mqe , 1 C . ‘ LIC. NO.: SC; 7(t% 6 Licensee: Signature CPC. LIC. NO.: (If applicable, enter "exc!empt" iii the liven a nu er line.) Bus. Tel. No.: SOS-W)" Co Address: CA rIOVCC \/ erk ©CA, 5 ' ik4 PkWSSa l Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, securitywork 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) 0 owner 0 owner's agent. Owner/Agent I PERMIT FEE: $ Signature Telephone No.