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Home My WebLink AboutBLDE-22-004328 Commonwealth of Official Use Only - :LIU Massachusetts Permit No. BLDE-22-004328 9 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:2/3/2022 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) 7 COTTAGE DR Owner or Tenant SENESAC JOHN R Telephone No. Owner's Address SENESAC MARY ANN,7 COTTAGE DR,WEST YARMOUTH, MA 02673 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: Replace meter disconnect. 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- ElNo.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 Initiatiine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ts No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Alertine Devices Space/Area HeatingKW No.of Dishwashers Local ❑ Municipal ❑ Other:Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Value of Electrical Work: (Whenq p p y') 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: Ray W Bombardier LIC.NO.: 33621 Licensee: Ray W Bombardier Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.N o. Address:PO BOX 2443, MASHPEE MA 026498443 *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 ❑ owner's agent. I Owner/Agent (PERMIT FEE: $50.00 Signature Telephone No. sa2iett 74,,/ vim RECEIVED <1 o *wealth o/Ma-mad:um& Official Use Only l o 0 3 2U22 c� Permit No. i22- ZE, - . FEBr P�nsnt o/_tire Servicee i vU I I_ F PREVENTION REGULATIONS Rev.Occupancy pry and Fee Checked r ay _ (leave blank) A- PLICATION FOIi PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod( C),5 CMR12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( 3' d?"' City or Town of: IALM,q)f) To the Inspector o Wires: By this application the undersigned g es notice of his or her intention to perform the electrical work described below. Location(Street&Number) C art A CI e. () " kr e, Map Parcel# Owner or Tenant V A A(L (4-N iv G e p. .4 511 C" Telephone No.`7 714 i5; 0-- Owner's Address Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 1 E0 Amps 0-0 / c),110 Volts Overhead Undgrd 0 No.of Meters New Service 109 Amps / , C/Volts Overhead R{ Undgrd❑ No.of Meters Number of Feeders and Ampacity -11 1 00 Location and Nature of Proposed Electrical Work: 0.122L,AGg-0 V11 Flea_ Di 5(tit.) ..) ) 1 174 Ai ev) re~(P.(LDIScaNN - A AO Neu-) Go-00Noi1-91 Completion of the following table may be waived by the Inspector of Wires. otal No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 1 Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Lrmergency Lighting grnd. aced. 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 ta No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices Heat Pump Number Tons ((KW No.of Self-Contained No.of Waste Disposers Totals: �f Detection/Ale Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal; ❑ O; Connection No.of Dryers Heating Appliances ICW No.-Security Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications quiv No.of Devices or Equivalent OTHER: / Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of El trical Work: J 0 00 (When required by municipal policy.) Work to Stan: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g. BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties ofperJury,that the information on this application is true and complete i FIRM NAME:RAI q/Ot`k S Q i;t!L ELL€c•i+�C t Aki LIC.NO.:0`.5 5 gyp. j'4 Licensee: Signature 14j(kiy c L LIC.NO.: (If applicable enter"exempt"in the license number line.) Bus.Tel.No.: f OW W Address: 3 'i„j U Y W lielr 4 `►A Off.i�i-I i Alt.Tel.No.:)0. ?ti a .- *Per M.G.L.c. 147,s.57-61,security work requires Dejiartinent 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)0 owner 0 owner's agent Owner/Agent Signature Telephone No. I PERMIT FEE:$ * Na rr,i fur thew til iotinn of emnlro riafantnro Ciro therm inenentinne're nerfnernn'1 by thew Cn hmrinn ntrierlinfinn• IMPORTANT:A separate permit is rcy�„�,cur u,c,,,��,��Qi,�,