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Home My WebLink AboutBLDE-21-006214 ►, Commonwealth of Official Use Only It�; '�� Massachusetts Permit No. BLDE-21-006214 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:4/27/2021 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 elo . Location(Street&Number) 61 HOMESTEAD LN JUg • 36 Li - Sr ' '5 Owner or Tenant GRENIER MARK R Telephone No. Owner's Address 61 HOMESTEAD LN,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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: Wire shed in yard. 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 rnd e 0 In- ❑ No.of Emergency Lighting g 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 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 0 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 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: 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 ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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:$250.00 qtI 1St (u/ 0 /cx /Yt � v>: J « Ig07Alb r"--- tq'A AO YS?AV Kg. ' 17/Wiq—C ) 44-PL ir"Lr -RA '--60231 60-. *ft/2i tit ..— 14 Cmuno m alg ///faeeaeLoatrs Official Use On " '' cc�� % Permit No. '(o zt \ 0 ' 1Japarfinref o`,..tins_c.a. _ Occupancy and Fee Checked 4 BOARD OF FIRE PREVENTION REGULATIONS [Rev. Iro7j (leave blank) (A 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: / R ( � 12 t ?,D Z City or Town of: y�/4i M Oi J1�-F (�OiRT To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. (1�1) Location(Street&Number) 61 'Hari E S7F-A 0 LAr4 E Owner or Tenant (44P K G RGN 1 e R. Telephone -Us q-SO055 Owner's Address Co( 1-I-0 M EfjTF.alp 1_444 a Is this permit in conjunction with a building permit? Yes 0 No X (Check Ap to ;•. t C Purpose of Building SHED Utility Authorization No. tin„ fir 4- 4. Existing Service Amps / Volts Overhead❑ Undgrd❑ o. eters d A i New Service V Amps / Volts Overhead 0 Undgrd deter — gr Number of Feeders and Ampacity T Location oKn and �Nature /o�f Proposed/ Electrical Work: QEt�4G(}6p 5 IE1) 1 NIY4A () es 1S 0 &T wt.12lNf& ()ONE' Completion of the following table may be waived by the Invector of Wires. Total No.of Recessed Luminaires No.of Ce1l.-Susp.(Paddle)Fans To.of Transformers KVA CI No.of Luminaire Outlets No.of Hot Tubs Generators KVA T No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting 1 1 A In grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zon c� _ No.of Detection and G)l � -• p . z, No.of Switches No.of Gas Burners Total Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices '� Heat Pump Number Toes_ KW �Nio.of Self-Contained , No.of Waste Disposers Totals: I Detection/Ale . , Devices ' No.of Dishwashers Space/Area Heating KW Local❑ Co n ,lon 0 Dialer C No.of Dryers Heating Appliances KW .o No Systems:* onnect Devices or Equivalent No.of Water IiVI, No.of No.of Data Wiring. Heaters Signs Ballasts No.of Devices or uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or&nth t OTHER: vo Attach additional detail if desirei or as required by the Inspector of Wires. Estimated Value of Electrical Work: 100 (When required by municipal policy.) Work to Start:4•I • 20 t2 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 0 BOND 0 OTHER Pir(Specify:) I certify,wider the pains and penalties ofperjary,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: *Per M.G.L.c. 147,s.57-61,securitywork Alt.TeL No.: requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER• I am aware that the Licensee does not have the liability °Ice coverage normally required by law. By y s gna I ,I hereby waive this requirement. I am the(check one er ' Owner/Agent } 0 owner s agent. Signature Telephone No. CJ 0Qg 3 44j I PERMIT FEE:$ I 5GSS