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• t-i`9 Commonwealth of Official Use only
IEA` Massachusetts - Permit No. BLDE-19-002659
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/N INK OR TYPE ALL INFORMATION) Date:11/2/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 100 MAYFLOWER TERR
Owner or Tenant BALLAS JOHN S Telephone No.
Owner's Address BALLAS PATRICIA A, 100 MAYFLOWER TERR,SOUTH YARMOUTH, MA 02664
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 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 Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Transformers KVA �I
No.of Luminaire Outlets No.of Hot Tubs Generators 1 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
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers (feat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other:
Connection
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
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 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: MARK L AVERY
Licensee: Mark L Avery Signature LIC.NO.: 13272
&applicable,enter"exempt"in the license number line) Bus.Tel.No.:
Address:77 AGNES RD,SOUTH DENNIS MA 026602814 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
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: $75.00
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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: 11/2/18
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) 100 Mayflower Terrace
Owner or Tenant John Ballas - Telephone No. 617-851-8101
Owner's Address 100 Mayflower Terrace,S.Yarmouth MA 02664-1118
Is this permit in conjunction with a building permit? Yes ❑ No ❑■ (Check Appropriate Box)
Purpose of Building Single Family Residence Utility Authorization No.
Existing Service 200 Amps 120 / 240 Volts Overhead❑■ Undgrd❑ No.of Meters 1
New Service 200 Amps 120 / 240 Volts Overhead❑■ Undgrd ❑ No.of Meters 1
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replace service cable,install new 22kW standby generator
and service rated transfer switch. Permit for two inspections,trench and final.
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of KVA
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 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 AlertingDevices
Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal. ❑
Connection Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of No.of Devices or Equivalent
Heaters KW Data Wiring:
Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:Load sheet attached
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:11/1/18 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 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is tr and complete.
FIRM NAME: Mark L.Avery LIC.NO.:
Licensee: Mark L.Avery Signature �� ..--- LW.NO.:13272
(If applicable,enter"exempt"in the license number line) Bus.Tel.No.•so8-696-8890
Address: 77 Agnes Road.5.Dennis MA 02660
Alt.Tel.No.:n4e94462e
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. ss-002294
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 ant the(check one)0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $7S H