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HomeMy WebLinkAboutBLDE-23-003634 `� Massachusetts Commonwealth of Official Use Only " Likitt o� \ Permit No. BLDE-23-003634 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:1/4/2023 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 des below. Location(Street&Number) 14 ELM LN c 1 g4 3 3 CQp 'c. Owner or Tenant KEEFNER LAWRENCE W JR Telephone No. Owner's Address KEEFNER PATRICIA A, 14 ELM LANE, SOUTH YARMOUTH, MA 02664 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 sun room Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 4 No.of Ceil:Susp.(Paddle)Fans 1 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 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 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 of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: CAIO PEREIRA Signature LIC.NO.: 56752 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 8574650613 Address: 195 Brooks Street, East Boston MA 02128-4543 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: $75.00 ',.it (4r PA-/ 0 k) C/i i/z3 h till 14t L- e E P- — it 694A(D ) e 6 7/z k . - g4u(23 (vim r, :.\ Commomosaig 0/Marip.chmoott6 Official Use Only Permit No. . 2—' -5(o54--, r ....,:% .7. _ .: 2eparisseni°Pi":Serviced Occupancy and Fee Checked , F -,,,..„... BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) •,.3 ,....J 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),,/.2,8126 12_ City or Town of: 'taxa)0(1-1-11 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) 1 11 ‘? rn I ,-, a , Owner or Tenant Telephone No. Owner's Address c‘g Is this permit in conjunction with a building permit? Yes 17 No C (Check Appropriate Box) --3,„ Purpose of Building 4'0,1\-;\.k. I,\'\,ti Utility Authorization No. ,-7----,' Exisilag Service Amps / Volts Overhead 1 Undgrd LI1 No.of Meters New Service Amps Number of Feeders and Ampacity / Volts Overhead E Undgrd 0 No.of Meters Location and Nature of Proposed Electrical Work: T urn_t r do ,42,_ 50/ (Qom ii-, -, 0. id 5ecoon t A J , KOOVY\ vi Completion of the following table may be waived by the Inspector of Wires, \el No.of Total Q, No.of Recessed Luminaires IA No.of Ceil.-Susp.(Paddle)Fans Transformers KVA ,.. c)., No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ri In- 0 No.ot Emergency Lighting grad. " grad. Battery Units No.of Receptacle Outlets E. 10 No.of Oil Burners FIRE ALARMS No.of Zones .,... No.of Detection and -,---. No.of Switches No.of Gas Burners -,.. ,-.,.... Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local° ClounniciPitoin 0 Other Security Systems:4 No.of Dryers Heating Appliances KW No.of Devices or Equivalent No.of Water No.of No.of KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs INo.of Motors Total HP 'Telecommunications Wiring: I No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:i 3.1 Ci. (When required by municipal policy.) ,, , ,,,_ Work to Start: I 1,117) /10-4 J-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 lila BOND El OTHER 0 (Specify:) I certify,under the pains and penalties©f perjury,that the heformadon on this application is true and complete. FIRM NAME: Cd,0 Ga by i e.I V ere,ivot. PAr.c+rt calif) LIC.NO.: Licensee: r:k,i,C rele L(4 Signature Z ---e-------- LIC.NO.: 5 isa-e (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1 gr) '3(00ii 5 5+-, Lc z,,n..-11 , Ail/1. C Alt Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires 1Jepartment of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability it_ irance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) bv owner 1:1 owner's agent. Owner/Agent - -z...f Signature Telephone No. (I'D 'EP) —Li G5-0c. PERMIT FEE: $ - t ,