The URL can be used to link to this page

Home My WebLink AboutBLDE-22-004027 6114.. Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-004027 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:1/21/2022 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) 76 CAPT CHASE RD Owner or Tenant Nancy Vrell Telephone No. Owner's Address 76 CAPT CHASE RD,SOUTH YARMOUTH, MA 02664 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: Septic pump&alarm. 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 Qrnd. 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. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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 1 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: JEFFREY T FOSS Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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 RECEIVED JAN 2 0 2022 k--- ...... .NAA!� BUILDING- DEPARTNILr�17 _ Comnwnweatth.el Maeaachuea(te Offici I tdse- v 1' .B / f(nrsnf o`,} {� Permit No.�Z--Lk°27 - at ape ire-cokes 'o'J. i`i BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [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), 7 CMR .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,20 / 10\ City or Town of: YARMOUTH To the Inspect r of Wires: By this application the undersigned gives notice of his or hentention7 erform electrical work described below. Location(Street&Number) , - Owner or Tenant X J J Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building (Check Appropriate Box) IVY Utility Authorization No. `r \ Existing Service /00 Amps p6'/ aVi Volts Overhead ❑ Undgrd W. � No.of Meters t New Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters l Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 2 i i U 4 tq tjU Completion of the following table may be waived by the Inspector of Wires. No.of Recessed LuminairesNo.of No.of Ceil.-Susp.(Paddle)Fans Total �t No.of Luminaire Outlets Transformers KVA c‘ No.of Hot Tubs Generators KVA A No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting - grnd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of OU Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and i' No.of Ran es Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump _..._umber Tons KW No.oTSelf-Contained Totals: '•'� I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Heating Appliances KW Security Systems:* on ❑ �� No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Vt.- Telecommunications Wiringg: OTHER: No.of Devices or Equiva]ent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El trio Work: �- ' (When required by municipal policy.) Work to Start: I -O Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabilit insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coy ge is in force,and has exhibited proof of same to thepermit issuing office.CHECK ONE: INSURANCE- BOND ❑ OTHER 0 (Specify:)Jr',q� (e �-' t' /O�Z Z I certify,under the pains and penalties of perjury,that the information on t a FIRM NAME: pp rcation is true and complete. LIC.NO.: Licensee: /j f �� Signature LIC.NO.: C.; f '� (If applicable�e er' eyip 11�e ce m er line.jt tl Address. ( IP/ I // i/fi!/fir t�/L 414(7 Z Bus.Tel.No.• ..�W p� /*Per M.G.L.c. 147,s. ,security work requires,) ep/cartm/�rten4•t®offPublic ,J Alt.Tel.No.: a c� OWNER'S INSURANCEafety S"License: Lic.No. 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 a•ent. Owner/Agent Signature Telephone No. PERMIT FEE:$ .