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HomeMy WebLinkAboutBLDE-23-003963 4 Commonwealth of Official Use Only \A Massachusetts Permit No. BLDE-23-003963 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:1/20/2023 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) 10 SOUTH WEST DR Owner or Tenant NANCY BARBIERI 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. 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: Second floor addition&bathroom. 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 14 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 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: Licensee: JULIAN ROBINSON Signature LIC.NO.: 58376 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126 Santuit Road, Marstons Mills MA 02648 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: $150.00 A f13 114 + l.ommonwaalfh el/r/addachadatld Official Use Only " 11 �t �7 n Pemlit No. �Z 3 3c 3 eparinuni o/- a Serviced I a Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (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: City or Town of: YAR_M O UTH 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) I 0 $`''Jill t✓>t)4-12 vt ve. Owner or Tenant N 4 h Cj 6 4.,r(,;er^r Telephone No. Owner's Address (c $0L,4-t, we)"t- Or,,e_ Is this permit in conjunction with a building permit? Yes © No ❑ (Check Appropriate Box) Purpose of Building A S- 1 F tI,vt 3'e C r:1 A.- C/d q,- Utility Authorization No. Existing Service Amps -4'/ i l_0 Volts Overhead❑ Undgrd Q No.of Meters I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (.1 i) S f ti t.-S ,c-1L.,54 t H f o.((is( Uri^/-4i,r5 lnc,L 134t-1,hdr;, s1 y) Completion of the followingtable mf be waived by the Inspector of Wires. lb, No.of Recessed Luminaires No.of Cell-Stop.(Paddle)Fans No.of Transformers otal Transformers KVA 47.1 No.of Luminaire Outlets l z No.of Hot Tubs Generators KVA •i- No.of Luminaires Swimmin Pool Above In- No.of Emergency Lighting g _grad, grnd. ❑ Battery Units 41 No.of Receptacle Outlets I(. No.of Oil Burners FIRE ALARMS No.of Zones ~= No.of Switches No.of Cu Burners No.of Detection and Initiating Devices i I! No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons. KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area HeatingMunicipal P KW local❑Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No. No.of of WaterHeat KW No.of No.of Data Wiring:Dvices or Equivalent Signs Ballasts 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: y,0 0 c) (When required by municipal policy.) Work to Start: [1 I`(/2 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 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: S. IbrC- C.,,.o•' (1 /j LIC.NO.: 2 (3?C"Q Licensee:3r.rIs ��oi.�wir� Signature \li-�1, LIC.NO.: Y32C"B (If applicable,en((er"exempt"in the license number line.) Bus'Y Zv Address: (LC 5k.�.t-1.,4- j1/eti}acl't j?0 it""-Sf',f I1,I(jitl(4bL•'F Alt.Tel.No.: .Tel.No.• 3Gfl-G °Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot 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. I PERMIT FEE:$