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Home My WebLink AboutBLDE-21-005385 Commonwealth of Official Use Only It 0Massachusetts BLDE-21 No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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/N INK OR TYPE ALL INFORMATION) Date:3/19/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 77 NORTH DENNIS RD Owner or Tenant Dan Heman Telephone No. Owner's Address 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: Wiring of hot tu13(2O1ICKgIVI WAY). f Completion of the following to e 'd bf. ii •,•ct, of Wires. No.: ::::r :: No.: : ; 1c1 Fans Noof1 :lTf 4„,„No. s No. ubs 1 Generators No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergent 4 a grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of ® V 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 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 of perjury,that the information on this application is true and complete. FIRM NAME: TODD A HIGGINS Licensee: Todd A Higgins Signature LIC.NO.: 13438 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1958, ORLEANS MA 026531958 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: $65.00 ....- Commonwealthoil//laldac it! ,. Official Use(Onll'y7�) _ c4Y_ • ��_ eparfi>:cr�t o/ s Permit No. -;.--44F---:---- rr -_. l artriced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -`,�,`• [Rev- 1/07) (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,...3--/ f ' 4.24 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pridersigaiec,:1,wives notice of his or her intention to perform the Iectrical work described below. Location(Street&Number) JV ut;�5 7-'61Ze ' '•14---$i yyyi R-) AKA C) NL e ''-i.7 Owner or Tenant .D4 i— H VY)/1'A/ Telephone No.`f1,3 x.77-ys/j Owner's Address_ /9-VM e Is this permit in co n)unction with a building pest_? iris — No 0 (Check Appropriate Boz) Purpose of Building jZ j//Jeri 6..C. Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd It ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: t'Yia_//y \ G of ...5P/4 r�3 t\dvrJcxil, Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires , usP (p ) No.of Total No.of CeiL-S addle Fans Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above r-i In- No.of Emergency Lighting ted- ernd. 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 InitiatinP Devices No.of Ranges No.of Air Cond. Total Tons Tons No.of Alerting Devices No.of Waste Disposers Heat Pump i Number `Tons I KW No.of Self-Contained Totals:I I f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water , Heaters Signs Ballasts. allasts Data Wiring: No,of No.of No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Devices or Equivalent No.of Motors Total HP No. Wiring: - OTHER: No.of Devices or E.uivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work to Start: -/�' (When required by municipal policy.) �i 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 2 BOND ❑ OTHER 0 (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: - /C, Z L/G.. e ,t LIC.NO.: J,4 Licensee:7t✓�D . L!1 . !>/ S L,--3�/ 3 (Ifapplicable nfAer exempt in the lice e number lin 4 Signature �F�lr LIC.NO.: jo . Address. •G' �/.S �►` Cit=-� L�14'Yl s t�LI.A r 64_65--, Bus.Tel.N c S Per M.G.L. c. 147,s.57-61,security work requires D Alt.Tel.No.: OWNER'S INSURANCE WAVER I Department of Public Safety"S"License: Lic. No. required by law. Byam aware that the Licensee does not have the liability insurance coverage normally Owner/Agent my signature below,I hereby waive this requirement I am the(check one 0owner I Signature0 owner's a ent Telephone No. PERMIT FEE: $