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Home My WebLink AboutBLDE-22-002473 r,aCommonwealth of Official Use Only aE Massachusetts Permit No. BLDE-22-002473 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:10/30/2021 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) 274 NORTH MAIN ST Owner or Tenant Dara Harris 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace exterior service&upgrade grounding. 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 o In- ❑ No.of Emergency Lighting grnd. grad. 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. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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:) certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jeffrey T Foss Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 AN pd 50, 0-D �- _ RECEIVED CC# /Gbh OCT 2 9 2021 CCoAf y� aa[A►i ol i//aeeachuedfa official Uie Only �� ✓ n .' _ -2-Lp -•'ILDING DEPARTMENT cc77 nn Permit No. e:- 1 =-` v Occupancy and Fee Checked ': BOARD OF FIRE PREVENTION REGULATIONS (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),52 9MR 12. i*---J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: r Q oc p` City or Town of: YARMOUTH To the Inspeect° of Wir By this application the undersigned givog7i7fhis or i tentio. t. o the elerzicai work described below. Location(Street&Number / t Owner or Tenant i� 1 / ,• r . [ f 1 Telephone No. 5 4 776 fy >y Owner's Address 5-4 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) \ Purpose of Building Utility Auth rization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters <30 New Service /VC) Amps /1boi 2 olts Ove � d F I Undgrd 0 No.of Meters Number of Feeders and Ampadty _ anon and Nature of Pro sed Electrical Work: "lei e• r •. e - 41 Ar t, P e I i if" d , -- f ' /�k G' fj /I Completion of thejollowingtable mD.,be waived by the/npector of Wires. 1.4 No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tra.of Total nVA To �1 formers KVA �i No.of Luminaire Outlets No.of Hot Tubs Generators KVA ‘t- No.of Luminaires Swimmin poo( Above In- No.of Emergency Lighting g Qrnd. ❑ grad. ❑ Battery Units `� No.of Receptacle Outlets No.of OH Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and �- Initiating Devices II I No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number "Tons_ _ ,KW No.of Self-Contained Totals: "'" "" ' " " Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Locai 0 Municip� 0 CyonneMion No.of Dryers Heating Appliances KWS * No. f Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Dvices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: g Attach additional detail f desired,or as required by the Inspector of Wires. Estimated Value l c�fr'cal Work: Q // (When required by municipal policy.) Work to Start: Inspecti s to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 equival t. The undersigned certifies that such erage is in force,and has exhibited proof of a to the rmit issuing office. � qq CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I /j (2 /0 21-- I certify,under the pains and hies of perjury,that the information on this application is true and comp e. FIRM NAME:' LIC.NO.: Licensee: � ��r"" Signature ,�� f9 LIC.NO.: MSC ti/r6/ (/f applicable exempt" clig.) Bus.TeL No.. .. •Aarti Address: 5(1WI i(//jl !' Q Alt.TeL No.:ZI1IWW/t—�6 *Per M.G.L.c. 147,s.5 -61 security/ct' k requires parlment of• blic Safety"S"Lice se: 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)0 owner 0 owner's agent. Owner/Agent l Signature Telephone No. I PERMIT FEE:$