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HomeMy WebLinkAboutBLDE-23-004886 Commonwealth of Official Use Only -E�,,,� '441%, Massachusetts Permit No. BLDE-23-004886 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:3/7/2023 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 described below. Location(Street&Number) 926 ROUTE 6A Owner or Tenant LEON NARBONNE Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service(X2) in main building. 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 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/Alerting 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 Siens 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: JESSE R LING Licensee: Jesse R Ling Signature LIC.NO.: 15646 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1200,WEST CHATHAM MA 026691200 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: $50.00 ks(%a tC)r- 3110,3 1 ( PfrULI3$ 4 slits) 2..1C•-'Z La- al A. C,or.ror.wcaj o,///aLsach.:4.6c II• Official Use Only i G-_ I �3 y� =fit=_ : Z) ' nn Pernrt No. ca ✓ncrt of rc Jcrviccd BOARD OF FIRE PREVENTION REGULATIONS 1�1Rev 07 and Fee Checked I. Rea„blank) j APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accornce with the Massachusetts Electical Cade(MC),527 Clv R 12.00 (PLEASE PRINT LNINK OR TYPEAjL INFORII.ATION) Date: . .-21 23 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersim,ed gives notice of his or her intention to perform the elect-ical work described below. Location (Street&Number) (o �c.til.�t- C r I'F2. 6,'c) Owner or Tenant i_con /Uwf ,IN.`e.-- Telephone No. j; Owner's Address t'li.z,� S� `C.551 Is this permit in conjunction wit a building permit? Yes j No {Check Appropriate Box) Purpose of Vir4 Utility Authorization No. Existing Service (1.00 Amps at) /14CU Volts Overhead I Undgrd b No. of Meters 2 New Service ()Xo Amps 13° /e)--,4C.)Volts Overhead ."----- Undgrd No. of Meters Number of Feeders and Ampacity Pacckrd #2 41uMktvrl Location and Nature of Proposed EIectrical Work: y-c..„ a[t,h1 1t oc � 0Vtfj 1/ . - Icc),;_ 11\1 6Q4te k '"i•a-/ 'We, A-C, ..50 i\'- `)YS S ,`n�1.0,6«.1.15{1 Completion of the follawinz table may be waived by the Irsaector of hires. INo, of Recessed Luminaires No. of CeiI.-Susp.(Paddle)Fans Vo,O2 Total Transformers _ l No,of Luminaire Outlets No. of Hot Tubs Generators KVA • No, o tninaires Above --I In- No.or>✓merg- Lighting Swimming Pool 6rnd. J c-rnd. ❑ Battery U • y No. of Receptacle l Ats ,No,of Oil Burners IF ALARMS INo.of Zones No.of Switches '., of Gas Burners o.of Detection and No. of Ranges f To Initiating Devices ;No_ of Air - :.s !No.of Alerting Devices !No.of Waste Disposers Heat Pump Number : • KW iNo.of Self-Contained Totals: Detection/AIerting Devices No.of Dishwashers 1Space/Area . -ating KW °cal D Municipal Connection � �� INo. of Dryers Heati•j Appliances KWSecur sterns:" No. of Water No.of '.ces or Equivalent Heaters KW I. °f No. of Data Wiring: Signs Ballasts j No.of Devices or Equivalent 1 INo. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: 1 No.of Devices or Equivalent OTHER:4.2 J - —1' Or' Attach additional derail ifdesfred or as required by the Inspector of Wires. Estimated Value of Electrical Work: 't©O (When required by municipal policy) Work to Start: ^2,1- 3 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 ® BOND ❑ OTHER I certify under the pains and penalties o (Specify:) f perjury, that the information on this application is true and complete. FIRM NAME: I,_, _f, LLec-tQ0- ,ct;lr4►-kic_r-Z ,,/� LIC.NO.: � 1�- �1 �V Licensee: - ����CLr Signature -� .' LIC. NO. - 3 L{(If applicabl enter "exem license r. pt"in the licee tuber line.) , Address: 2°'� .(Zt:)O tom% ,C-NA-Cf'4f}1..r NPr , OX_C,(c;� Bus.Tel.No.: Sa - - 77L{ I "Per M.G.L. c. 147, s. 57-61,security work requires Depa,anent of Public Safety"S"License: Alt LicI No.No., _ a�7 . n 4 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5 required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ ownero ` Owner/Agent E owner's anent oi Signature Telephone No. PERMIT FEE: S V