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HomeMy WebLinkAboutBLDE-23-3445 �--\ Commonwealth of flaeeachuseffd Official Use Only N -W°-A �, cc�� c7 Serviced Permit No. `7 3 - r4 3.l`{` " 5 2eparfinenf o`Mira Serviced —.rrs ,. i;.-� Occupancy and Fee Checked V _`' '' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank) v` APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.0o Q- (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 12/15/2022 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) 41 Uncle Roberts Rd Owner or Tenant Peter Fairbanks Telephone No. Owner's Address P.O. Box 175 North Marshfield MA 02059 1 Is this permit in conjunction with a building permit? Yes c2v No ❑ (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. 11462383 5.,, Existing Service Amps / Volts Overhead n Undgrd n No.of Meters New Service 320 Amps 120/240 Volts Overhead E Undgrd g No.of Meters 1 Number of Feeders and Ampacity 6/250kcmil Location and Nature of Proposed Electrical Work: New Construction UG Permanent Service V) Completion of the following table may be waived by the Inspector of Wires. t :1) No.of Recessed Luminaires 50 No.of Ceil.-Susp.(Paddle)Fans No.of Total C Transformers KVA CI No.of Luminaire Outlets 20 No.of Hot Tubs Generators KVA No.of Luminaires 60 Swimming Pool Above ❑ In- /No.of Emergency Lighting vt grnd. grnd. Battery Units . No.of Receptacle Outlets 60 No.of Oil Burners FIRE ALARMS No.of Zones oNo.of Switches 60 No.of Gas Burners 1 No. Initiating Devices I l No.of Ranges 1 No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW *No.of Self-Contained Totals: 3 13 Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local❑ Municipal ❑ Other Connectionyy No.of Dryers 1 Heating Appliances KW Securitys:* f Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters 1 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNofDeiceor Equivalent No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires, Estimated Value of Electrical Work: 1 15360.00 (When required by municipal policy.) Work to Start: 1/15/2023 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 c2r 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: Coastal Mechanical LIC.NO.: 22967-A Licensee: Jon T Moreau Signature C, 62G LIC.NO.: 8082 Al (If applicable,enter"exempt'.in the license number line.) Bus.Tel.No..4Q8-7 =$_747 Address: 21 L h ruean Ave S. Yarmouth MA 02 4 Alt.Tel.No.:5 32 9Fa9 *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/Agent Signature Telephone No. PERMIT FEE: $ 200.00