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Home My WebLink AboutBLDE-22-000504 -1V Commonwealth of Official Use Only E 4. Massachusetts Permit No. BLDE-22-000504 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:7/27/2021 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) 7 NANTUCKET AVE Owner or Tenant WALLIN JAMES Telephone No. Owner's Address WALLIN ANNA, 134S COUNTY RIDGE DRIVE,AMSTERDAM, NY 12010 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A ropriate Box) Purpose of Building Utility Authorization No. 0 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 . . a New Service 100 Amps Volts Overhead 0 Undgrd 0/ �y ett�1 Number of Feeders and Ampacity 4.1 . `litMr ZZLocation and Nature of Proposed Electrical Work: Upgrade service. Completion of the following table may b• sL ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ttal Transformers A No.of Luminaire Outlets No.of Hot Tubs Generators A No.of Luminaires Swimming Pool Above 0 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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs ,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: THOMAS J MADDEN Licensee: Thomas J Madden Signature LIC.NO.: 14065 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 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:1 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 Teel " Telephone No. PERMIT FEE:$50.00 2, r Commonwealth o`1//addachudsl'id Official Use Only SO t-1 . ,;A.;w �CJs/vartinsnt ol,}ira ServicedPermit No, I�ZZ—O ' (- < Occupancy and Fee Checked c BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 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: 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) 7,/1,1,"1-J -. kerr- f v-e .S j,, c ✓'./4 Owner or Tenant CT.✓A et l/t' Telephone No. 56 e- 9 6 9 S�3o r Owner's Address 0 /X 3 66 S'i yu✓•,0 L, Is this permit in conjunction n ith a building permit? Yes ❑ No [(- (Check Appropriate Box) Purpose of Building A'.p 5 / Utility Authorization No. Existing Service ),DO Amps /r- /49yNolts Overhead[(-----Undgrd❑ No.of Meters 7 New Service /) Amps/4 /r 0),Volts Ove head Undgrd❑ No.of Meters 1 Number of Feeders and Ampacity a ,eV y j1i 17J Location and Nature !X posed Electrical Work: S",e r/v t G es' C „�j �v c l 0 C c>rr0,s / v vl Completion of the followingtable may be waived by the In ector of Wires. NA No.of Recessed Luminaires No.of Cell:Sus No.of Total o,fp.(Paddle)Fans Transformers KVA `ZI No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4" No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting �rnd. and. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones hNo.of Switches No.of Gas Burners -No.of Detection and r Initiating Devices No.of Ranges No.of Mr Cond. Tons) No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:1....._...._... } �..._ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:1 No.of Water No.of No.of Devices or Equivalent Heaters ' Data Wiring: No.of 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 o Elec 'cal Wor : r ai Oa (When required by municipal policy.) Work to Start: 7 Inspebtions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVE GE: 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 a 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 ai sad enalties er ury,that the information on this application is true and complete.'J FIRM N Z we rjc 'c A LIC.NO.: f 7(7 L 5'A- Licensee: 0 ` eci Signature �'�/�; (If applicable,enter"exempt"in the license number line.) g '^-` t LIC.NO.: 7�f Address: Bus.Tel.No.:_�� i� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No.Tel.No.: 05 �77 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does trot 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. I PERMIT FEE:$ 1