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Home My WebLink AboutBLDE-22-003897 4\ w` Commonwealth of Official Use Only f�111% Massachusetts Permit No. BLDE-22-003897 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:1/13/2022 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) 15 ERICKSON WAY Owner or Tenant OLEARY TIMOTHY J JR Telephone No. Owner's Address OLEARY ANNE M, 15 ERICKSON WAY, SOUTH YARMOUTH, MA 02664-2201 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service 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 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 Ton 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 No.of Devices or Equivalent HeatersWater KW No.of No.of Ballasts Data Wiring: 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: 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 TYfrC , / et C&ip uNol>u 6 4 eceliiveo up) RECEIVED (,(J % // ,(,/ a 1BAN 2 2022 Co ea&of/f/amachumdis Official Use Only n - `47 DING ULIt'ARTM T Z ,!: -`..1! - P ? ='' of ol.=- irs Jsrvu:sd Permit No, ��— t, ! b BOARD OF FIRE PREVENTION REGULATIONS ';,,�,.,,�'" Occupancy and Fee Checked ------__.___ � Rev. 1/07J leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK lj'7‘......s. : All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27CM 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) /°1 v7-2 of Wires: City or Town of: YARMOUTH Date: By this application the undersigned gives f his intention to To the ele electrical work k, Location(Street&Number) �' C tf r ( described below. Owner or Tenant fZet Owner's Address Telephone No. 99 Is this permit in conjunction with a building permit? Yes 0 No (,� Purpose of Building (Check Appropriate Box) Existing Service AO Am Utility Au horization No. ps M /. d Volts Overhead d Und r M �, ^'ice Amps Undgrd No.of Meters p ' Volts Overhead Und rd Number of Feeders and Ampadty (� g El No.of Meters I44 Poo:ati/ 1 and Natur 1Al Pro EI cal rk: e Com,letion o the ollowin, table m, be waived b the! , ctor o Wires. No lb No,of Recessed Luminaires No.of Cell.-Su `o.o sP-(Paddle)Fana Transformers KVA Kt No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,t: No.of Luminaires Swimming Pool ' 'Ve ,n-d. ❑ 'o.o mergency g ,ng t No.of Receptacle Outlets nd. ❑ Batte Units -� No.of OH Burners FIRE ALARMS No.of Zones -e. No.of Switches No.of Gas Burners `o.o t etec on an l 1 i No.of Ranges Initiatin, Devices No.of Air Cond. ota No.of Waste Disposers `eat ump 'um,er n Tons No.of Alerting Devices Totals:'ump ...'_um,er• .. _..on._...._. ' r. `o.o e out: n , No.of Dishwashers Detection/Alert , . Devices Space/Area Heating KW 'un c No.of Dryers Heating Appliances Local❑ Connection 0 Other 'o.o "a er KW `o.o 'o.o KW ca ty ystems: Heaters No.of Devices or E uivalent S L ns Ballasts Data Wiring: No.of Devices or E,uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ea I ons " ,g. OTHER: No.of Devices or E.uivalent "— Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of tri Work; Work to Start: / (Whenrequired by municipal policy.) SURANCE C Inspections to be requested in accordance with MEC Rule 10,and upon completion. GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabili insurance including"completed operation"coverage or its substantial equivalent. undersigned certifies that such coy ge is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE permit issuing office. The I certify,under the pains and BOND ❑ OTHER ❑ (Specify:) FIRM NAME: penalties ofperfury, the Information on thrs � �i�t�� '�,2 ry' pica en is true and complete. Licensee: .e LIC.NO.: (If applicable. t "ere pt ,! e!' a Signature Address: rline.) LIC.NO..-- =+L3:31 *Per M.G.L.c. 47,s.57-61,security work requires Department of Public Safety S L censer Bus.Tel.No. 9`r/ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityAlt.Tel.No.: (1 required by law. BymysignatureLic.No. Owner/Agent below,I herebywaive this requirement, I am the(check on insurance coverage n�ormaljy Signature / owner ■ owner's a:exit. Telephone No. PERMIT FEE:$