HomeMy WebLinkAboutBLDE-24-1809 Nail Spa _ __ Commonwealth of Massachusetts Official Use 1y-.
_� . Permit No.: E-7---‘.-I .4b
Ii;- Department of Fire Services Occupancy and Fee Checked:
'11 " BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] •
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 5 7 , 1�.0
City or Town of: YARMOUTH Date f •1'
To the Inspector of Wires:By this licati n,th dcrsign gives ces his or her intention to perform the clectrijnl wo described tow.
• Location(Street&Number): off( C Unit No.:
Owner or Tenant: !T� �L d 'ijg i / Email:
Owner's Address:( Phone No.:
Is this permit in conjuncts n with bus in ermit?(Check appropriate box)Yes❑ No❑Permit No.:
Purpose of Building: //c '/f f C Utility Authorization No.:
Existing Service: Amp / Volts Overhead 0 Underground❑ No.of Meters:
New Service: Amps / Volts 0 erhead Underground❑ o.of Meters:
Description of Proposed Electri al Installation: r �tr e ed D 0 /1e�
Completion of the following table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No:Motors: Total HP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool:In-Grnd.0 Above-Grnd.❑ Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices:
No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System ❑ No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount❑ Level 1 0 Level 2 0 Level 3 ❑ Rating:
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electri 1 W k: (When required by municipal policy) •
Date Work to Start: // Ili 7 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: ( A-1 ❑or C-1 ❑LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: Fri / I, '' c.t7 LIC.No.: 7 r6 �r
Security System Business requi es a Division f Occupdtional Licensure"S"LIC. S-LIC.No.:
Address: �/I l9� �jn; /� Qf l�tf d/qJ< 73
Email: G eTelephone No.: (2 " ? V
I certify,um4 the pain enal •of perjury,that the i or nation on r'•application is true and complete.
Licensee: . !�Z�l1i� Print Name: 447, (tt»t','/C' ti/ Cell.No.: 77 g
INSURANCE COVERAGE Unless waived by the owner,no permit for the performce of electrical work may issue unless the licensee
. provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage
is in force and has exhibited proof of me to the permit issuing office.
CHECK ONE: INSURANCE BOND 0 OTHER❑ Specify:
OWNER'S INSURANCE AIVER: 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: Tel.No.:
Signature: Email.: