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HomeMy WebLinkAboutBLDE-23-005118 Commonwealth of Official Use Only (dt4t#1 Massachusetts Permit No. BLDE-23-005118 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:3/17/2023 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) 357 LONG POND DR 6 II-(0?,7-(V$7 Owner or Tenant MELANIE KHEDERIAN Telephone No. Owner's Address 357 LONG POND DR, 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 1YMtgcs New Service Amps Volts Overhead 0 Undgrd 0 No.-of Miters / Number of Feeders and Ampacity i'y. I /_ Location and Nature of Proposed Electrical Work: Fans, lights, &receptacles _ ,, Completion of the following table may be waj/- ,by.the InspeLtdr of Wires. L/: . t No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of sform r �'/, ,- Tout. Tra `' P! No.of Luminaire Outlets No.of Hot Tubs . ±. 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 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: 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 RECEIVED �.__..-._._..� .a el M Lat Official Use Only MAR 16 202 ../ S'.,ri. Permit No. -77 —St 3UIL Occupancy and Fee Checked ',� Be LyTP EVENTION REGULATIONS [Rev.i/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: March 10,2023 City or Town of: South Yarmouth To the Inspector of Wires: E By this application the undersigned gives notice of his or her intention to perform the electrical work described below. o Location(Street&Number) 357 Long Pond Drive,South Yarmouth.MA 02664 1 Owner or Tenant Owner Telephone No. 617-694-1057 E Owner's Address 357 Long Pond Drive,South Yarmouth,MA 02664 he CaJ Is this permit in conjunction with a building permit? Yes ® No El (Check Appropriate Box) GPurpose of Building Covered Porch Utility Authorization No. Existing Service 200 Amps / 240 Volts Overhead© Undgrd❑ No.of Meters 1 INew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Outside Covered Roof-Fansiights,&Plugs Installation (3 y N-6 torn.\ Completion of thefollowinEtable m be waived by the Inspector of Wires, lb SOfP(Paddle) Transformers KVA No.of Recessed Luminaires No.of Cell Fans No.of No. Total S Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA `1 Above In- No.of It mergency Lighting 't; No.of Luminaires Swimming Pool grad. ❑ grad. ❑ Battery Units :-2 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection gon and Zr. Initiating Devices I Ll No.of Ranges No.of Air Cond. Tons No.of Alerting Devices rs Heat Pump Number Tons KW No.of Self-Contained No.of Waste Di sposers Totals: —_...._..._____....__.............. Detection/AiertlsDevices No.of Dishwashers Space/Area Heating KW Local❑Connocpglio.n 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: KW Heaters Signs Ballasts No.of Devices or EquivalentNo.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: li 2tSC.,O (When required by municipal policy.) Work to Start:3l2(.122_ 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 ofperjury,that the information on this application is true and complete. FIRM NAME: 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.L.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 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/AgentPERMIT FEE:$ SignaatureureTelephone No.