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Home My WebLink AboutBLDE-22-001834 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-001834 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:9/30/2021 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) 1 TAFT RD Owner or Tenant SEARS JOANNE T Telephone No. Owner's Address 1 TAFT RD,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: Replacement HVAC. 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 Lig r� grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALA' w+ ofto No.of Switches No.of Gas Burners 1 No.of Detectio • ' ` N.( Initiatme Devices No.of Ranges No.of Air Cond. 1 Tonal No.of Alerting Device No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained 4 o 0 Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Sims 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: ANDREW G THOMAS Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 ECHO LN, CHATHAM MA 02633 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: $50.00 kt k s(zt tCQ=Z0 ()NJ , __\ Commonwealth o/masoac1 uaetfa Official Use Only P_:2,2.,-- /6 3L i.......,.— ii._ t Permit No. Ji Apartment o` ire Sirvice4 _= Occupancy and Fee Checked °�$j" BOARD OF FIRE PREVENTION REGULATIONS [Rev. 107) / (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: S C on, a v' f City or Town of: `'(4(r oti i tt To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertbrnt the electrical work described below. Location(Street&Number) 4 'I/4f i c-o4J Owner or Tenant Do fin o t .5 e ,-,s S Telephone No. Owner's Address 1 TA C.3' f 0 ti ci Is this permit in conjunction with a buildingermit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building {t 5.Z s 7` t( Utility Authorization No. Existing Service \ 0 0 Amps (a o/d K 0 Volts Overhead ta' Undgrd❑ No.of Meters New Service Amps / Volts Overhead n Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Itt f)sc t r c' i f-✓rN h et ¢ A` ` Completion of the,following table may be waived by the Inspector of Wires. No. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans 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 I 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. V Total a 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 ❑ Other Connection HeatingAppliances Security S stems:" No.of Dryers pp KW 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 TelecommunicationsNofDeieorWiring:q No.of Devices Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 11.$5o,o0 (When required by municipal policy.) Work to Start: St ri a.3,.2 0d 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BONI) ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. r.‘ FIRM NAME: ltia M til{,C41,cc l St/1/,i,S 1n L LIC.NO.: tq2 1 Sd ✓c Licensee: A►)art(,- No A.S. Signature Ctjv's 6-. LIC.NO.: (If applicable,enter "exempt"in the license lumber line.) Bus.Tel.No.: 41-7` 5')5- Ttli Address: 7 &C 4 6 1k 41 Alt.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires 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: $