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HomeMy WebLinkAboutBLDE-23-004731 ^� Commonwealth of Official Use Only f ' Massachusetts �` Permit No. BLDE-23-004731 ALA g(. -23- es3 �-' 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:2/27/2023 City or Town of: YARMOUTH To the l pectorofWires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 361 ROUTE 6A Owner or Tenant ANDREW BANKS Telephone No. /� Owner's Address 361 ROUTE 6A,YARMOUTH PORT,MA 02675 //`�� Is this permit in conjunction with a building permit? Yes❑ No ❑ (Ch ropri>< x) Purpose of Building Utility Authorization No. �RL- ?/'''"/Q�7 f Existing Service 100 Amps Volts Overhead ❑ Undgrd ❑ VVVVVV� `o *efiys � New Service 200 Amps Volts Overhead 0 Undgrd 0 1�Wo ' t� ��5� r Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 200 Amp U/G service with Ufer grounding. '� `s 7 Completion of the following table may be waive1Vp•1r/�.},Qector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of total Transformers VA 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal C 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 Sim s No.of Devices or Equivalent No.Hydramassage 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 penaldes of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL S SOBY Licensee: MICHAEL S SOBY Signature LIC.NO.: 10097 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:66 Lake Dr,Orleans MA 02653 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:$230.00 ^^__ \....4 14 Commonwealth o f Ma�3ac lb Official Use Only 77 '' 1 Permit No. fi3 .t4 7 2spartmenL of Jiro SePVK6J s w 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: �j G � , 4. City or Town of: �,e/1140 To the Inspector of Wires: By this application the undersigned wes notice of hisher intention to perform the electrical work described below. ..-5 Location (Street & Number) .,- Owner or Tenant larGIoS•Ifire..5Telephone No. Owner's Address •�+ Is this permit in conjunction with a ' ding perm' 7 Yes ELL No C (Check Appropriate Box) Purpose of Building!/ lt04--ei iLj)i.7l/a/ UtilitY Authorization No. Existing Service /QZ) Amps Alp ` Volts Over ad 41 Undgrd n No. of Meters New Service C Amps / Volts Overhead [1 Undgrd A.,. No. of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Ele 'cal Work: 0,144 i ylel 5eiet/i j_____ //0.5-77qa • , 141/016/9A iipt 6z,, e0144 - 4. .....-- 1....,,,„--,-)1._ 47 v Completion of the oll �ti=in le may be waived by the Inspector of Wires. � P .fp 11) No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total �f Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA a No. of Luminaires Swimmin Pool Above ❑ In- ❑ No. of Emergency Lighting ggrnd. 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 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 ❑ munieipal Connection ❑ Other No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent H dromassa a Bathtubs No. of Motors Total HP 'Telecommunications Wiring: No. y g No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work:,7afp�- (When required by municipal policy.) Work to Start: t5 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C ©ERAGE: Unless waived bythe owner, nopermit for theperformance of electrical work mayissue 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 roit BOND ❑ OTHER 0 (Specify:) I certify, under the pains and penalties of perju that the information on this application is true and complete. FIRM NAME: -A. r, / „ LIC. NO.: Ar Licensee: I1 .4,. Allaili,siMir Signature /i/ ( LIC. NO.: r,. (If applicable, e er "exempt 'i ice ve n • r line. s. Tel. No.: - -•" 345- Address: if . - 1 'S ' -. /, f . / ✓. P......10--. t. Tel. No.: *Per M.G.L. c. 147, s. 5 -61, security wo - require sep. t of Public .fety "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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $