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Home My WebLink AboutBLDE-22-002957 al Ye Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002957 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:11/21/2021 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) 45 CARRIAGE LN Owner or Tenant Charles Dean Telephone No. Owner's Address 45 CARRIAGE LANE,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 ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for pool house. 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 0 In- 0 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 Siens 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 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: HENRY LARKOWSKI Licensee: Henry Larkowski Signature LIC.NO.: 26990 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:91 HOKUM ROCK RD,PO BOX 267,DENNIS MA 026380267 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: $150.00 awn/non/m=1th of 7 7.66.1.4.ffi Official Use Only '* 97 Il -f/ c� �77 �1 Permit No. �7i2-- �g Apartment of.1sre Serviced _ 51 , Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (1ea1t blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK Mi work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT701s9 Date: 1/ /2, 2. City or Town of: YARMOUTH To the Inspector of Wires_ By this application the tmdersigned giv notice of his or her intention to perfa a electrical work described below. Location(Street&Number) �. PSL/ i4c3 Z A__L Owner or Tenant n ij S JJj' S A3 17C;fr Telephone No. Owner's Address e Is this permit in conjunction with a bruding permit? Yes [X No ❑ (Check Appropriate Box) Purpose of Building { 'O6 I- / DO Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 Ne.of Meters Number of Feeders and Ampacity 2 6.L., i. 1 c-'-U aid]) Location and Nature of Proposed Electrical Work: (,If/peCr j,J4,,D s Completion of thefollowing;table may be waived by the Inspector of Wires. oTotal No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Faits T � KVA No.of Luminaire Outlets No.of Sot Tubs Generators KVA No.of Emergency Lighting No.of Luminaires Swimming Pool A0.nd. ❑ grid. ❑ Battery tints No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas BurnersInitiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices HeatP I Number 1 Tons {KW -No.of Self-Contained Detection/Alertin Devi No.of Waste Disposers ces Maiticipal No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other Heating Appliances KW 'Security Systems:* No.of Dryers Na of Devices or Equivalent -No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wirin : No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent O I'liER Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of len Work`U% Q(}o (When required by municipal policy.) Work to Start: 4 e inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VE 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 overage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) /2 Z I certify,under the pains and enalties of perjury,that the info n this application is true and complete. FIRM NAME: 10 r ' LIC NO.: Licensee: /[ t) • Signature r a.:1 _ ,`.!, LIC.NO.:L (0. e v (If applicab nt exempt"i the linens ber li a Bus.TeL No.' r . Address.YOU/-00 3C (e7 t( "l M74 02- 23 Alt.Tel.No.: Miie' J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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. SOwner/Agent PERMIT FEE: S 1 Signature Telephone No. .