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Home My WebLink AboutBLDE-21-005933 or tit& Commonwealth of Official Use Only 111% Massachusetts Permit No. BLDE-21-005933 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/14/2021 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) 5 BEACH RD Owner or Tenant BOOTH JEFFREY Telephone No. Owner's Address 354 ASHFORD RD,TOMS RIVER, NJ 08755 /0. Is this permit in conjunction with a building permit? Yes 0 No ❑ ( heck Appropriate Box) Wit `/ Purpose of Building Utility Authoriza on No. 5450773 615/8110 Vita Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 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 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 of perjury,that the information on this application is true and complete. FIRM NAME: PAUL J VIOLETTE Licensee: Paul J Violette Signature LIC.NO.: 20858 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 ANCHOR DR, FORESTDALE MA 026441822 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 1( )' -51C Commonmaatth of///assachusstts Official Use Only 3'3 �-- ..UaParfma et ol.1zre Serviced Permit No. � '� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: y i,. i City or Town of: YARMOUTH �r To the Inspector o Wzres.• By this application the Imdersigned gives notice of his or her intention to perfprm the electrical work described below. Location(Street&Number) /3 i c 4 /2 Cs , Owner or Tenant , /-7,---) P 4�d �,L,,,4, Telephone No. Owner's Address Orn L-cc Li e,cc) ( 0�,-+ o;,i P1 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building if/.4-fv► - Utility Authorization No. 5 s ') "7 "7 3 Existing Service %Lo Amps 11,E I„lit,. Volts Overhead 2"- Und grd❑ No.of Meters i New Service 1 G U Amps ,J)Q I)(-/6 Volts Overhead E---' Undgrd 0 No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: / Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceal.zSusp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No,of)imergency Lighting grad 0 arnd. 0 BatteryUnits No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.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 No.of Waste Disposers Heat p als:1 Number I Tons I KW No.of Self-Contained Detection/Alerting Devices V No.of Dishwashers Space/Area HeatingKWMunicipal Local❑Connection 0 Other No.of Dryers Heating Appliances , "Security Systems:* `� No.of Water KW No.of Devices or Equivalent No.of No.of Heaters Data Wiring: Signs Ballasts No.of Devices or Equivalent u No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent c4 OTHER: Attach additional detail if desired or as required by the Inspector of Wires. - Estimated Value of Electrical Work -N Work to Start: S /„1, (When required by municipal policy.) ,I Inspections to be requested in accordance with MEC Rule 10,and upon completion. Vs' INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless o the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such ccerj.es.is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 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: o It'. 4- - F7,,,-rl r, LLL LIC.NO.:. Licensee: Pc ,,, i r. J t Le,4 f_t_ Signature P c1„,...e. )(If applicable,enter "exempt"in the license number line.) t„), LIC.NO. Address: jC an,LW,- n;t..-t7 r4./e j- ba y� Bus.Tel.No.: J *Per M.G.L. c. 147,s.57-61,securitywork requires l+n, Alt.TeL No.: 0 Department of Public Safety"S"License: Lic.No. � S �-S ,,— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�— S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner 0 owner's a ent. , Owner/Agent I Signature Telephone No. PERMIT FEE: $