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HomeMy WebLinkAboutBLDE-22-003986 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003986 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:1/19/2022 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) 37 MIDSTREAM DR Owner or Tenant GARDINER ROBERT C Telephone No. Owner's Address GARDINER THERESA D, 111 HAVILAND ST, QUINCY, MA 02170 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 eters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Miscellaneous work per attached. t` 9 Completion of the following table may be wdfv�by the Inspector of Wires. No.of Recessed Luminaires 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 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiative 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 0 Municipal ❑ 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 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 ❑ 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: Matthew P Logan Licensee: Matthew P Logan Signature LIC.NO.: 20915 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:303 SANDWICH ST, PLYMOUTH MA 023606503 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 Pe n yqry�� I g4 Comasamcoaa o/rr/addac4a4etis Official Use Only p k.....:, ryy. ��77 [[i� Pemat No.� 2—3 1 r.,C 1— .. �� 2opariewni n`Jiro Jowled I1-11 Occupancy and Fee Checked .q 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 (M ),527 CMR 12.00 (PLEASE PRINT IN INK OR TyPE ALL INFORMATION) Date: I 61 2O72 JCity or Town of: j br tno,0-' To the I pector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 211 ril lc Sirecav" L Owner or Tenant 3v10 C,.r terns•! Telephone No. JOwner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building R...SI,\k'.i1�,k' Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters er Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `.101,t,,t.,I, co( raj(T, Oat/c. Gtd rem f(J+- }Or new . '.,i old work Sw,ft-r•, hoc co'-hroI new unc(.vwbt%.tt 4.40( tItoptr cabi....f low whiny_il,Lth Completion of the followingtable m be waived by the In vector of Wires. lb No.of Recessed Luminaires No.of Ceil.-Sa (Paddle)Fans Na. sfo Total sP• Transformers KVA Z Cl No.of Luminaire Outlets No.of Hot Tubs Generators KVA a Above In- No.of Emergency Lighting ' No.of Luminaires , Swimming Pool grnd. ❑ grnd. ❑ Battery Units J 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 I U No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained lm Totals: Detection/Alerting_Devices Mu No.of Dishwashers Space/Area Heating KW Loral❑Cyonnecnicdtlopal n ❑if No.of Dryers Heating Appliances KW 'Security of Device s or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devicesor alert OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work:t I'd STr-, (When required by municipal policy.) Work to Start:j f I c1 Lt>2L Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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❑ (Specify:) I certfy,under the pains and penalties of peslnry,that the Informadan on this application is true and complete. FIRM NAME: i�" i)L E''e err,c,:..I (as("rau1'or., Si.. LIC.NO.: AO (S Iq Licensee: mtn�ytew I, (,,... Signature LIC.NO.: (Ifcpplicabe,Mill" /a'me neve number line.) Bus.Tel.No.7g I S3I 50 i7 Address: 303 .54t.cl'-'"G. 5/ p/y,,,a..fk 111. 02360 AIL TeLNo.: *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 ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.