The URL can be used to link to this page

Home My WebLink AboutBLDE-22-005426 LeV-\ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005426 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:3/29/2022 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) 18 PINE GROVE VILLAGE Owner or Tenant KIRKPATRICK JOHN Telephone No. Owner's Address C/O ANDREW DIAMOND, 18 PINE GROVE VILLAGE,YARMOUTH PORT, MA 02675 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Adding rooms in basement. 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 PoolAbove ❑ In- ❑ No.of Emergency Lighting $rnd. 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 Initiatine 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/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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent 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:) C-013a I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jason Violette Licensee: Jason Violette Signature LIC.NO.: 51767 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 QUEENS BAY LN, BOURNE MA 025325571 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:$75.00 PAW ( 4'4111 -gt4 (z& . __ RECEIVED .A, MAR 2 5 202 f �j - .._s. meaciumelid Official Use Only o •a oi nis - :'k=i-,.° 7J ' DING DEPART cc�� n Permit No, ZZ- j" - i r :p --- muni o f,tiK Jirv/eed 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( EC),527 CMR 12.00 O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) —1-- Date: 2,5-j a�• City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Ives no.ce of his or her inten'onto .-, orm the electrical work described below. Location(Street&Number) (�" , �'t► , Owner or Tenant rlir� • .. ) ,S ,�►(. , 1 5 "I i S 5� Telephone No. Uc6-Oro 5- S5 �i Owner's Address r I �-f/c --GY Is this permit in conjunc n wi a b Idi , ,. '_ ,-° _ r rmit? Yes No 0 (Check Appropriate Box) - Purpose of Building 1) n) 1 t yy�fii Utility Authorization No. Existing Service \OJ Amps / Volts Overhead 0 Undgrd Volts Overhead ❑ No.of Meters U' New Service Amps / d 0 Undgrd ❑ No.of Meters Number of Feeders and Ampadty I I Location and Nature of Proposed Electrical Work: a \ — CoNsr\ ) c- b:vpui,,f,)v `f° Completion of the following_table m be waived by the Inspector of Wires. ev Lik No.of Recessed Luminaires No.of Ce11,-Snap.(Paddle)Fans No.oto otai �t No.of Luminaire OutletsTransformers KVA r;�, No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting - �" No.of Receptacle Outlets trod. ❑ gjrnd. ❑ Battery Units No.of 011 Burners FIRE ALARMS INo.of Zones v. No.of Switches No.of Gas Burners No.of Detection and Ranges 11 No.of Initiating Devices No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste DisposersHeat Pump Number Tons KW No.of Self-Contained Totals:I_ -�. �" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers Heating Appliances KW Security Systems:*on ❑ Other No.of WaterNo.of No.of Devices or Equivalent Heaters No.of , Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring, OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lee 'cal Work:c� (When required by municipal policy.) Work to Start: 3 Q5o�ca Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 cerdfy,under lite ns and pe /ifes a p fury,th �a^In mallets on I is application is true and complete. FIRM N 0 11 o p- :. IS(�-( Gm Licensee: ! , LIC.NO.: �1 !� �► I a. "s e Signature ` I ►.� (If applicable, :• t"in the lie`�num line.) �.,.��i] LIC.NO.: (� Address: ( 4QY)�j rl.0g >1' ��0 0 S �A `' Bus.Tel.No.• - _ ci 7 4k) *Per M.G.L.c. 147,s.57-61,security wo uires Department of Public Safer •1S"License: Alt LiTel. •No.• ti OWNER'S INSURANCE WAIVER: I aware that the Licensee does not have the liability insurance coveragenormally — 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 Signature Telephone No. I PERMIT FEE:$ 75-- 1