HomeMy WebLinkAboutBLDE-21-004407 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-004407
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
iRev.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:2/4/2021
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 below.
Location(Street&Number) 74 OCEAN AVE
Owner or Tenant Anthony Decaclo Telephone No.
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 Amps Volts Overhead 0 Undgrd ❑ No.of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Replace all devices and install two fan/lights.
Completion of the following table may he 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 O KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of E. .y., �,Ligitt(r
grnd. grnd. :$
Battery s• �?
No.of Receptacle Outlets No.of Oil Burners FIRE ALAR
c 'ni
No.of Switches No.of Gas Burners No of g n �� OV
.InitiatingD DetectionDevices
a C
^
No.of Ranges No.of Air Cond. Totalons No.of Alerting DevicesT </A`�r
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices Q
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ O
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 us required be 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: ARTHUR P DOHERTY
Licensee: Arthur P Doherty Signature LIC.NO.: 17197
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:372 YARMOUTH RD,HYANNIS MA 026012043 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:$50.00
cc Commonwealth of Official Use Only
Ali%- Massachusetts Permit No. BLDE-21-004407
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•2/4/2021
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 below.
Location(Street&Number) 74 OCEAN AVE
Owner or Tenant Anthony Decaclo Telephone No.
Owner's Address
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 all devices and install two fan/lights.
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 0 KVA
No.of Luminaires SwimmingPool Above ❑ In- 0 No.of E�,jt� ., Li
grnd. grad. 4 , v
Battery b .4 ip, 0
No.of Receptacle Outlets No.of Oil Burners FIRE ALAR i
b
No.of Switches No.of Gas Burners No.of Detection a O
Initiating Devices / O
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
Totals: Detection/Alerting Devices O
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ O .
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: ARTHUR P DOHERTY
Licensee: Arthur P Doherty Signature LIC.NO.: 17197
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:372 YARMOUTH RD, HYANNIS MA 026012043 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: $50.00
wHi CAII UJHe i R-e b y
-.
C'oeouvoa .of rr/aseacl Official Use only tt
• ,1 Permit No. �.— LA`k 6i i �oparddont s.,..., Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS
i‘g
o = [Rev.1/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accedence with the Massachusetts Electrical Codq(MEC).527 CMR 12.00
(PLEASE PRJIVT IN INK OR TYPE ALL JNFQRM4TIQM Date: 2._/3/26Z f
ti City or Town of: YARMOUTH To the Inspectf Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 79 c e24)a/ A v-e_
of Owner or Tenant AN 7 1!/JU y% ,De A(L.Q Telephone No.
Owner's Address f
• o Is this permit in conjunction with a building permit? Yes 0 No I (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ - Undgrd❑ • No.of Meters •
L.
.. New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
', Number of Feeders and Ampadty
V Location and Nature of Proposed Electrical Work: keph4 ct ALL bet c.,e-5 Til( T' 14-11401e4 Nov'
be ADD 2 I34-1-4 PAA//L-; (r "
Completion of thefollowingtable may be waived by the Inlisector of Wires.
ZWTotal
No.of Recessed Luminaires No.of Cel[.-Snip.(Paddle)Fans To.of EVA
Transformers KVA
c) No.of Luminaire Outlets No.of Hot Tubs Generators KVA
k No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting
s g grad. ❑ surd. ❑ Battery Units
`l No.of Receptacle'Outlets No.of Oil Burners FIRE ALARMS No.of Zones
r No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices •
1 LI No.of Ranges No.of Air Cond. Toon No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/ Devces
No.of Dishwashers Space/Area Heating KW Local❑ Mnnidpaa ❑ Other.
• Connection
DryersHeating AppliancesKW Securityems:*
No.of Nf Devices or Equivalent _
No.of Water ICVir Ro.of No.of Data Wiring:
Heaters Signs . Ballasts No.of Devices or Equivalent
Na Hydromassage Bathtubs No.of Motors Total HP • Teiecommunnicatfons Wing:
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 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 ❑ OTHER 0 (Specify:) -
I eerdfy,under the pains and penalties ofpe jam',that the Wormation on this application is true and complete
• FIRM NAME:RA/ 5)- I //_Grr,CA L Cho Tr-A c_7'0->=� Lic.No.:A/7/9 7 ,
Licensee:Co l e.m0.n Cos-rel to Signature � �Am L' LIC.NO.:
(If applicable.enter•"exempt"in the license number line.) Bus.Tel.No.:
Address: ,j-7 /t?,D 74,c,1f Dr ft/, A,l/'•?0 071 HA O2 73 Alk Tel.No.:S-6 R- 72./o-0007
*Per M.G.L.c. 147,s.57-61,security work r�aires Department 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)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$