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HomeMy WebLinkAboutBLDE-23-003257 .'4,1 "-c Commonwealth of Official Use Only ,.."A Massachusetts Permit No. BLDE-23-003257 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:12/12/2022 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) 9 FROST AVE Owner or Tenant ROBERT WRAY Telephone No. Owner's Address MA 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: Rewire basement Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 20 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 20 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TTottal No.of Alerting Devices n No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 5 Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 94 qt.est5 i: 6 (-`26401 ',V( Nk, i e23 .___,, boil( Cal( r�k.zu— r-ecich( RECEIVED Eyy��DEC 12 20�� Cmmoruvea/th of Massachiaeefie Official Use Only ,.WS y l�, PermitNo.l.1—Z7'3 2.57 BUILDING D1_F,-,. i,,.. 5� epartmenio to Serviced BB -- --'V'71--P. 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: /y/2/Z0 Z Z City or Town of: _ZYARMOUTH To the Insp ctor f Wires: By this application the undersign grve7vnotice�is or hery intention to perform the electrical work described below. Location(Street&Number) e /vGr7S/ %t UG Owner or Tenant z)i),2AJ45z_ Telephone No..5r2 33 2.-49603 } Owner's Address ,6 V57 / cJ Lr),'5 7--"V °e ai ff 14Y7/1= 0ZE --3 Is this permit In conjunction with a building‘ermit? *esNo ❑ (Check Appropriate Box) Purpose of Building ' Utility Authorization No. Existing Service v''''Amps / Volts Overhead❑ Undgrd Er No.of Meters i New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty 1 Location and Nature of Proposed Electrical Work: f t,( n'�✓'� � cv � vl Vi Completion of the followinktable may be waived by the Inspector of Wires. Us No.of Recessed Luminaires Z :Susp. :5 No.of (Paddle)CeilNo.of Total ni Fans Transformers KVA C1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA C/ A No.of Luminaires Swimming Pool Above ❑ Io- ❑'No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets 2 7 No.of Oil Burners ,FIRE ALARMS No.of Zones 5 No.of Switches I 0 No.of Gas Burners No.of Detection and Initiating Devices 't' No.of Ranges Na.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers -Z.— Beat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers / Space/Area Heating KW Local❑Municipal ❑Olh Connection No.of Dryers / Heating Appliances KW Security Systems:* No.of No.of Water a 1 KW No.of No.of Data Wiringvices or Equivalent HeatSigns 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: (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❑ BOND❑ OTHER 0 (Specify:) I certify,under the pains,/� and penalties ofperJury,that the in�rmarlon on this application is true and complete. FIRM NAME: K:ohz->L( I'`17.706(_t/> (A/4-7 LIC.NO.: Licensee: Signature / LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.' Address: Alt.Tel.No.: Per M.G.C.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot have the liability insurance coverage normally required by law. By my signs elow,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No.�g.33Q, Z16©7 PERMIT FEE:$ 7s-cal