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Home My WebLink AboutBLDE-22-006291 '", 0 Commonwealth ofOfficial Use Only ft* ek\ Massachusetts Permit No. BLDE-22-006291 :27 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:5/2/2022 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) 938 ROUTE 6A Owner or Tenant 011ie Orman Telephone No. Owner's Address 938 MAIN ST,YARMOUTH PORT, MA 02675-2172 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: Inspection for PREP ARE! fr'�--_ Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: No.of Total Susp.(Paddle)Fans Transformers KV,,� 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/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 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: ROBERT F THIBEAULT Licensee: Robert F Thibeault Signature LIC.NO.: 22475 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:36 GOVENOR BRADFORD RD, BREWSTER MA 026312806 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. ! 1/ FEE: $80.00 2to =111.11/ (iw' a ti - 21(3/7/am c . par-% 1NF.1wJ_>Iwd-,', _�la-line [- ;� C tth_` Official Use Only ommonwea `7 aeeac uesffe ZZU^ ;, Ci �7 Permit No.O'22. )2$ •L. -"pia;.',r. �spartmsai?o`�ir+s Serviced ir 9,1-7: 4 Occupancy and Fee Checked Q 3 A. 4:: 'a �'RD 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),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .57I/2.,-2- City Zlz2City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform th electrical work described below. Location(Street&Number) S 6`� - f 13 g Kar-6A Owner or Tenant Q C-CdE d)Z-OteN £-e- C- Telephone No. Owner's Address S'9yt.I, lIs this permit in conjunction with a building permit? Yes 21 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. fig-/$ 3 7 Existing Service `-- Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service `1`t'0 Amps /20 / 2-LW Volts Overhead❑ Undgrd g No.of Meters 3 Number of Feeders and Ampacity Z - fir) s Location and Nature of Proposed Electrical Work: go v �- I C142 g_ p/tep 424,6-1.9 , ,,k 'I) Completion of thefollowin&table m be waived by the Inspector of Wires. id.,: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.oil Total 0/ Transformers KVA 'Z1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA CA -t No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Lmergency Lighting grnd. grnd. Battery Units yNo.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones -- No.of Switches No.of Gas Burners -No.of Detection and h Initiating Devices t; No.of Ran es No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Nurnber Tons KW -No.of Self-Contained p Totals: Detection/Alerting )evices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 1--1 other Connection HeatingAppliances KW No.of Dryers pp Security Systems:*No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent WiNo.Hydromassage Bathtubs No.of Motors Total HP Telecommunications el No. f Devices oor 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:,�J22- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 07'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 El BOND 0 OTHER 0 (Specify:) /i e x'c , r`PZ---12-Z.-- I -1z--I certify,under the pains and penalties of perjury.that the information on this application is true and complete. FIRM NAME: ,e i I' &-42.2c--,- C?7U C f N �,/��_ 4, LIC.NO.: Licensee: 'YIP -Ti�'/1'G (.1cy� Signa / LIC.NO.: GyZ ,-/-2a (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 72 )-I)3 q Address: 7 6 Cdr- 6 ) . i1.-15 AV. 154,5W-grin--01.4-(72k.3( 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 PERMIT FEE:$ Signature Telephone No.