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Home My WebLink AboutBLDE-22-001832 Commonwealth of Official Use Only �. q q) Massachusetts Permit No. BLDE-22-001832 _ 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:9/30/2021 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 SQUIRREL RUN Owner or Tenant David Lear Telephone No. Owner's Address 45 SQUIRREL RUN,YARMOUTH PORT, MA 02675-1835 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 receptacle for fire place blower. 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 1 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 Tons 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 KW No.of No.of Ballasts Data Wiring: Heaters ,Signs 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 ,g /6/6/7,1e. Commonwealth o/MaMachusett.1 Official Use Onl ► = /, c� 1 l (77 /\� Permit No. & — re,1. 1M .2 epariment of_Tire Service4 __ Occupancy and Fee Checked ',f 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 LL INFORMATION) Date: 9-Z?-Z 1 City or Town of: /14tt7N To the Inspector of Wires: By this application the undersigned gi es notice of his or her intention to perform the electrical work described below. Location(Street&Number) y5 ,S eg u t 2Rst'L Rvi 7' '/'t'1T Owner or Tenant j./A0,i) i r-y40._ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ri No (Check Appropriate Box) Purpose of Building Re-sb o>`tr„kt i).,,ve-ZL,,,,,t, Utility Authorization No. Existing Service Amps / Volts Overhead n Undgrd❑ No.of Meters New Service Amps / Volts Overhead Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /rJsrit-tL a.ect- rtc..1,r t /ST PC.o04 ak /---/;t2g AJICE 2 6.-s i eq Sele r. Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf Tot Transformers KVA } No.of Luminaire Outlets No.of Hot Tubs Generators KVA v Above In- No.of Emergency Lighting N• o.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units iNo.of Receptacle Outlets Q No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas BurnersCond. Total No.of Detection and Initiating Devices No.of Ranges No.of Air No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained ci Totals: Detection/Alerting Devices '^ No.of Dishwashers Space/Area Heating KW Local ElMunicipal ❑ Other 't: Connection Heatin A ltances Security Systems:* j No.of Dryers g pp KW No.of Devices or Equivalent O No.of Water K,�, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: No.H y g No.of Devices or Equivalent Cj OTHER: J 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: Q-30--Z1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. w 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 El' 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: l4k« p,e 1 6A-4 .1q..4 t3 ELL-7Ti2 a t LIC.NO.: Licensee: _ ,►'3,E,�_ Signature — LIC.NO.: 4Z 1�`/3 (If applicable,enter"exem,(�t"in license number line.) Bus.Tel.No.:Sei r" 39✓3411 Address: e/3s- /1� /3 V Sdir 4 t)rs),JAJI t 0 Z La(o 1) Alt.Tel.No.: x/O) *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: $