HomeMy WebLinkAboutBLDE-21-000158 Commonwealth of Official Use Only
O.Alt&
Massachusetts
Permit No. BLDE-21-000158
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:7/13/2020
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) 56 BROOKHILL LN
Owner or Tenant QUINN EDWARD P II Telephone No.
Owner's Address QUINN ANN R, 149 28 HAWTHORNE AVENUE, FLUSHING, NY 11355
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App 'ate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd 0 kit o.of 44S.
t "
New Service Amps Volts Overhead 0 Undgrd 0
Number of Feeders and Ampacity i1°.' !0 /5 f r
Location and Nature of Proposed Electrical Work: Install generator.
ii O 4°P4P
Completion of the following table may be wai,: b r of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of
Transformers
No.of Luminaire Outlets No.of Hot Tubs Generators 1 �/ A 15
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/Alertinc 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:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: SCOTT D MORRIS
Licensee: Scott D Morris Signature LIC.NO.: 18338
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:PO BOX 1264, HARWICH MA 026456264 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
Commonwealth of Massachusetts Official Use Only
i 47 Permit No. E. � —0(5 t3
� 2-,‘Department of Fire Services
% Occupancy and Fee Checked
''- --iv BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]y
(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: 07/10/2020
City or Town of: Yarmouth To the Inspector o Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical •j s, • '.ed below.
Location(Street&Number) 56 Brookhill Lane CE. ,
Owner or Tenant Quinn Tele,ho e No
Owner's Address JUL 13 Z020EI
Is this permit in conjunction with a building permit? Yes ❑ No ® (Chec•Ap• • e Box) 1
Purpose of Building Residential Utility Authorizatio iL pi"G O
Existing Service Amps Volts Overhead ❑ Undgrd❑ No.of Mee ;
New Service Amps Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and-*" "^"„vn^, •Llee--;—'-"'- • _ _ _ u'• • ^--r 15KW generator.(Transfer Switch was existing)
waived by the Inspector of Wires
No.of Rece e)Fans No.of Total
�� Transformers KVA
?BACCL(No.of LumIt/ Generators KVA
No.of Lum ❑ In- ❑ No.of Emergency Lighting
grnd. Battery Units
No.of Rece FIRE ALARMS No.of Zones
No.of Switi (2-- Q��e-IQ i No.of Detection and
Initiating Devices
No.of Rang Total No.o
f AlertingDevices
Tons
No.of Wast Tons KW No.of Self-Contained
Detection/Alertin Devices
No.of Dish' W Local❑ Municipal ❑ Other
Connection
No.of Drye KW Security Systems:*
No.of Devices or Equivalent
No.of Wate No.of Data Wiring:
He Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications o Devices
or EquiWirivalent No.of Devices 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: 07/07/2020 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 pro. •f same to the permit issuing office.
CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Speci•,:)
I cert, under the pains and penalties ofperjuty, that the informatio o his application is/r%e and complete.
FIRM NAME: SDM Electric,Inc. LIC.NO.: 18338A
Licensee: Scott D.Morris Signat , rd 40 „.-/j,,_4 LIC.NO.: 38090E
(If applicable, enter "exempt"in the license number line.) es- Bus.Tel.No.: 508 430 4014
Address: PO Box 1264 East Harwich,MA 02645 Alt.Tel.No.: 774 353 6902
*Per M.G.L.c.147,s. 57-61,security work requires De.. : t of Public Safety"S"License: Email:scottmorris@sdmelectric.com
OWNER'S INSURANCE WAIVER: I am aware tha e Licensee does not have the liability insurance coverage normally re-
quired by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.
4,11n
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