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Home My WebLink AboutBLDE-22-003192 Commonwealth of Official Use Only "'2� Massachusetts Permit No. BLDE-22-003192 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:12/6/2021 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) 18 NORTH SANDYSIDE LN Owner or Tenant LINK JUDITH A Telephone No. Owner's Address 60 WITHERELL DR, SUDBURY, MA 01776 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 ❑ 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: Ins ection for trench&conduits onl . Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Ceil.Susp.(Paddle)Fans . f r rs No.of Recessed Luminaires Generators KVA No.of Hot Tubs No.of Luminaire Outlets No.of Emergency Lighting Swimming Pool Above ❑ I rn-d. ❑ : •tt•t $'ts No.of Luminaires •rnd. FIRE ALARMS No.of Zones No.of Oil Burners No.of Receptacle Outlets No.of Detection and No.of Gas Burners Tat',. 1 • No.of Switches Total No.of Alerting Devices No.of Air Cond. „ No.of Ranges Tons =No.of Self-Contained Heat Pump - t •t• ti$1. • • ii' 1 •v' • No.of Waste Disposers T�t. Local 0 Municipal 0 Other: Space/Area Heating KW ,i • to No.of Dishwashers W Heating Appliances K ►o ' l • • ' 1 No.of Dryers No.of Ballasts Data Wiring: . I t No.of r No.t• Water KW Telecommunications Wiring: •at•r Total HP N, 1 • • •s ir $ a •it No.Hydromassage Bathtubs No.of Motors OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) WorkEstimated to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. li cen e INSURANCE COVERAGE:Unless waived by the owner,no permit for the perform performance of electrical lent.The undersignedyissuecertifiesunless the such see provides proof of liability insurance including"completed operation"coverage or its substantial is in force,and has exhibited proof of same to the permit issuingOTHER ❑ (Specify:) CHECK ONE:INSURANCE 0 BOND 0 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: 57427 Licensee: Te*�"r Rpbery Signature Bus.Tel.No.: (If applicable,enter"e "exempt"in the license number line.) Alt.Tel.No.: 5083640419 Address: 1 Carol Road,BUZZards Bay MA 02532 *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❑theo liability er ❑ owner'insurance s coverage en normally required by law.But my t. signature below,I hereby waive this requirement.I am the(check one) Owner/Agent PERMIT FEE: $50.00 Telephone No. Signature Mil -t Cact31 7 v 71'I IA b'-. Z- f DEC 0 2021 1 aa'' �j Cnwsaf rh o`MaddacLudsild Official Use Only \, n.. I,. i-zt �7 n Permit No, t.l�— J�92.— V ' •; +,. _� _ .Xs (mod ol3ire Serviced 0 M .;^;.1,F Occupancy and Fee Checked b _,, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) { � APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK -/V 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: /2 — — ,,,, ./ is t 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 electr. work described bf w. Location(Street&Number) /1i-- * S�9/v.b J <6 J /9/ /�a'4 2/ 1�d�� Telephone No. Owner or Tenant �� q,e C�/�/C ,A / //g g"--- C/ _5.S 18 Owner's Address /( , Sff-/i(,f6 Ar Lit l 11,,,, Is this permit in conjunction with a building rmit? Yes ❑ No (Check Appropriate Box) W Purpose of Building l if/E O Utility Authorization No. y... Lu. Existing Service Amps //a to o Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters C\ Number of Feeders and Ampacity \.[E Location and Nature of Proposed Electrical Work: —7 -Je f /N_ ,J A;vC sox 770 h c_ „k �— /i 1, t/ //2 .lkup Completion of the followingtable maybe waived by the Inspector of Wires. Ik No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total 0/ Transformers KVA '=,t No.of Luminaire Outlets No.of Hot Tubs Generators KVA At No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ �rnd. ❑ 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 11 No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: ..•.. Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Locai 0 Connection 0 Other 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: 77 qJ 4L 2-A/S,Fe77041 Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: I 000, C1J(When required by municipal policy.) Work to Start: /02.--,,a ,2 (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 cove ge 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 pa fp and penalties ofpe�erjury,that the information on this application is true and complete. FIRM NAME: O GL / LIC.NO.: ,>2el& 2-Z Licensee: (pal pA F Signature IC.NO.: (Iffapplicabl(pal ter"e e►mpt"in the lice a numb line.) us.Tel.No.; SDS 36y—Qq(9 Address: 7 �, /tal / D tU 27sfiiry c /S /1A-- 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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$