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Home My WebLink AboutBLDE-22-006197 y� A\X Commonwealth of0Official Use Only _ Massachusetts Permit No. BLDE-22-006197 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:4/27/2022 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 ZEPHYR DR Owner or Tenant MArk Simbajon Telephone No. Owner's Address 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 30 amp twist loc&manual transfer switch. 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- CINo.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 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 ❑ 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 Stens 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: A J PULLEY Licensee: A J Pulley Signature LIC.NO.: 21843 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:289 QUAKER MEETING HOUSE,RD,E SANDWICH MA 025371366 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 ( /7v 1 Commoncvea�of Madoacueeted iccial Use On y 1=: g:/, Permit No. �Lz—�19 IC 1pa tmant ol }ire Sepvicets1111 Occupancy and Fee Checked IV P Y -- 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: 4-Z(o -22- City 22City or Town of: /412 w.eonl To the Inspector of Wires: By this application the undersignedes notice of his or her intention to perform the electrical work described below. Location(Street&Number) /Z Zg-P4)//2. ha- Owner or Tenant 14.4 A it-if- $,,,,,.RA. 1 G,./ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No n (Check Appropriate Box) Purpose of Building /SEs,-,,,r,4,,_ ,,.,es,,,.,c,. Utility Authorization No. Existing Service /t)v Amps /20/ Zi.(()Volts Overhead Undgrd n No.of Meters / New Service _ Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: w iezc3,-;A Tw,jr_1_0,w_ ,1 iD--cuts r 14,1.4/Vt,,A L 112 AI SFS,L Sw,rrW 44 /%,tr, /7tF 6L.7%.,ex,d-rt it. Completion of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting p4`e r grnd. grnd. Battery Units No.of Receptacle - () No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No. Initiatingon Detectionand Devices No.of Ranges No.of Air Cond. Total Tons 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 ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 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: 4/-247-22... 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 [-BOND El OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: /.1,4 a UH foA S .4n1,1 L--Ler ra.ic- LIC.NO.: Licensee: 4 1.AAA El Signature LIC.NO.: AL1Y�/3 (If applicable,enkr "exempt"ih/the license number line.) Bus.Tel.No.: Spur 34f-'34'31 Address: L).a30x /1401 01 So,J ru. 17p,n,,i i s, 1444 O7i,t ) 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)El owner El owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $