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HomeMy WebLinkAboutBLDE-23-003588 Commonwealth of Official Use Only ,� Permit No. BLDE-23-003588 �. Massachusetts 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:12/31/2022 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. 1 A Location(Street&Number) 70 JOSHUA BAKER RD , Owner or Tenant KARRAS THEODORE K SR Telephone$o. Owner's Address KARRAS MARY LOU G,70 JOSHUA BAKER RD,WEST YARMOUTH, MA 02673 ^y Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) "'`, Purpose of Building Utility Authorization No. 11451007 Existing Service Amps Volts Overhead 0 Undgrd ❑ 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: Install generator Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 14 Above In- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool ❑ grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ Other: HeatingAppliances KW Security Systems:* No.of Dryers pp No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HPNo.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: Michael D Hollister Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD,S YARMOUTH MA 026641017 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: $50.00 Rwr,,--fr: i/ 2c� CyrWea D)/ ': Commonwealth o/rr/aaaaciiadrlla Official Use Only �Z3—35�� U `."s:Y; "A"e .g C� ;e;,; rP nI el in rwicre Permit No. 1 I-a Occupancy and Fee Checked Si .1(7 BOARD OF FIRE PREV [Rev.REGULATIONS Rev.1/07 (leave blan'e)' APPLICATION FOR PERMIT TO PERFORM ELECTRIuAL WORIV� All work to be performed in accordance with the Massachusetts Electrical Code(MEC)j`527 CMR 12.00 L. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /2 I7.,42'— MOUTH To the Inspect ro City or Town of: 6 YAR_ fWi By this application the undersigned gives notice of his or her intention to orm the electrical d ribed below. ,Q Location(Street&Number) 71j -re)s(4,3 (a 6 4�L Owner or Tenant , F� y}�2 W Telephone No. -1 ( t J Owner's Address Is this permit in conjuuctio with a building permit? Yes ❑ No J3.. (Check Appropriate Box) Purpose of Building 1 C3 t( '"✓C f E Utility Authorization No. I I' 5/©G 7 rY Existing Service // Amps 1,A 7�/Volts Overhead Undgrd l �I l r f ` g ❑ No.of Meters New Service Amps / Volts Overhead E Undgrd❑ No.of Meters Number of Feeders and Ampadty ,..--/ K (A A i c)WK/ � �& ma- ti Location and Nature of Proposed Electrical Work: ,P 0, J w • Completion of the following table may be waived by the Inspector of Wires. o Li No.of Recessed Luminaires No.of Ce1L-Soap.(Paddle)Fans No.of lotal Transformers KVA ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA d;• No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting yrnd. ❑ grad. ❑ Battery Units Z.:i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones c. No.of Switches No.of Gas Burners No.Initiatof ing Devices I1! No.of Ranges No.of Air Cond. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump Nu__m__b_er,Tons._..,KW_ No.of Self-Contained Totals:_ ' Detection/Alertins Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑Connection ❑Otb� No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of Na.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of E ttiA ork: 3 D e 0 (When required by municipal policy.) Work to Start: 2/ i' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE GE: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 nettles ofpe�ryiury,thJ t the Information on this application is true and complete. FIRM NAME: jtij I G l-//� 6- i/ 1, 6e-I yj" LIC.NO.:/UO 7/- i?j Licensee: F/"1'�s// r t,� Signature�j LIC.NO.: (If applicable,ant empt"in the license number Brit) ^�} _ ,�i Bus.Tel.No: 7 7te S 3 1 Address: i)S'/fi, QL ziM t S i(r(� ///7V,✓�l Gi/( '-'" 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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$