The URL can be used to link to this page

Home My WebLink AboutBLDE-22-005255 Commonwealth of Official Use Only M kCI, Massachusetts Permit No. BLDE-22-005255 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:3/21/2022 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) 12 MARSH SIDE DR Owner or Tenant WALD JAN DAVID TRS Telephone No. Owner's Address WALD DONNA MARIE TRS, 12 MARSH SIDE DR,YARMOUTH PORT, MA 02675 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: Replacement HVAC. 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 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Totalo No.of Alerting Devices ni No.of Waste Disposers Heat Pump Number , Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Ballasts Data Wiring: Heaters Slims No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 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: Sean C Rogan Licensee: Sean C Rogan Signature LIC.NO.: 20141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 MELIX AVE, PLYMOUTH MA 023601280 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 L 7( i - 11 gfigerli lij ill Ca-1( RECEIVED LMAR 18 211ECommome el V aeeac its .... ,.._ �+ fficinl use Onl I N G D i- _is __ T �7 eu l l D srifkes !_. r" � �f ,� ire Permit No. 7i2— 55- �' .w BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 59 All work to b:performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 PRINT IN INK OR TYPE ALL INFORMATION) � � City or Town of: YARM ' , u Date:_ .5/ �'/,z-Z LBy this application the undersigned gives notice of Oor he intention to To the enspector of wok described ocation(Street&Number) perform the electrical work described below. Owner or Tenant jpri t del Telephone No.Owner's Address `7?, g1../ 7 S N N Is this permit in conjunction with a building Purpose of Building ,QiwG/��^r permit? Yes 0 No (Check Appropriate Box) Utility Authorization No. Raiding Service Amps / Volts Overhead rJ New Service 0 Undgrd❑ No.of Meters _ N Amps / Volts Overhead 0 Undgrd V) Number of Paden and Ampadty g ❑ No.of Meters I Iroeation and Nature of Proposed Electrical Work: /4f, A d c z/hln to 'te lon, the oliowi : table rn, be waived b the I Lb No.of Recessed Luminaires for o Wires. �✓ Na otCdl.-Snap.(Paddle)Fans 'o•o eta Na of 1Luminahe Outlets Transformers KVA Na of Hot Tubs Generators KVA ` No.of Luminaires Swimming Pool ,� , d e rn n- 'O.o 'Units mergency ' ;ng " No.of Receptacle Outlets °d• ❑ Bette Units .,` No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Cu.Burners 'a o i , on an, Initlada Devices v. No.of Air Cond. o• rl.t No.of Alerting g Devices • �, 'o.o No.of Waste Disposers atTatabmp °�� r ens moo ._.. oo� a > a of Dishwashers _..• DetectbNAlertin Devices Space/Area Heating KW 'us i^rn Na of era Local 0 Connection 0 Other o.o D a r Heating Appliances KW • y ,e.: Neaten KW o.o `o.o No.of Devices or uivalent S•_ ,s Ballasts• Data Wiring: No,Aydromas:sge Bathtubs No. of Devices or ' ,trivalent No.of Motors e ecomm ; .ns r OTHER: Total HPg Na of Devices or • ,ulva7ent Estimated Value of Electrical Work: Attach addition al detail'desired,or as required by Me Work to Start: �//g-/�2.. (When required by municipal policy.) Inspector of Wires. Inspections to be requested in accordance with MEC Rule 10,and INSURANCE COVERAGE: Unless waived by the owner,no the'licensee providespermit for the upon completion. proof of liability insurance including"completed performance of electrical work may issue unless wtdasitpted certifies that such cov is in force,and � operation"coverage or its substantial unde ONE: INSURANCE has exhibited proof of same to theequivalent. The I Gerd ONE: "' BOND 0 OTHER 0 (Specify:) permit issuing office. FIRM NAME:n pains 5.l d nodes ofpe►Jury.that the information on this eerie_J app!leatlon is true and ea NO.: Licensee:--_ ,j of A/ LIC. ��J% / (If applicable,enter"exempt" signature Address: n the license number line. LIC.NO.: t. 261 *Per M.G.L.c. 147,s.57-61, pr.., • /�f Bus.TeL No.; al OWNER'S c. 14 security Wo require Delic AIL TeL No.. S INSURANCE WAIVER: I am aware that the Licensee does notSafes ws.•License: regyircd by law. Bymysignature Lic.No. Owner/Agent t3nature below,I hereby waive thishave the liability insurance coverage normally Signature eat requirement. I am the(check one i♦ owner , • owner's a:ent. Telephone No. PERMIT FEE:$