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Home My WebLink AboutBLDE-22-005406 Commonwealth of Official Use Only ' � Massachusetts Permit No. BLDE-22-005406 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:3/28/2022 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) 511 ROUTE 28 Owner or Tenant LUKE ARTHUR TR Telephone No. Owner's Address 511 MAIN STREET TR, 511 ROUTE 28,WEST YARMOUTH, MA 02673 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: Install receptacle for ice retail machine. 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. Batten,Units No.of Receptacle Outlets 1 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. Total 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 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 Sinus No.of Devices or Eauivalent 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 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: $80.00 CON-X:17— (f/ f?_ -- (c€ Q0-7('251-.4(: , __ Common-wealth of//lassac et! Orificial Use Only nz-94 O6 =4t=- Apartment cc-77 n Permit No. 0 r Z =./1�=i Apartment of/...�`irc Jcrviced IjJ 1 W =;>= Occupancy and Fee Checked C%1 i Y ;,. , BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07) (leave blank) -°— C R I APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK LU 1 C\2 i All work to be performed in accordance with the Massachusetts Electrical Code C), 7 CMR 12.00 U Q i z j "LEASE PRINT IN INK OR TYPE ALL INFORM4 TION) Date: 3 y c) Z- ° 1 LU i m City or Town of: YARMOUTH To the Inspect r of Wires: cel i m m:y this application the pndersigned gives notice of his or her intention to perform the electrical work described below. • ,ovation(Street&Number) 5 1/ rO rn S )- 12 F ? ' Owner or Tenant /i L. (4. k-Z_ Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes — No E------(Check Appropriate Box) Purpose of Building Re Ie , I Utility Authorization No. Existing Service Amps / Volts Overhead _ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ` �. y l G �^ 1 3 t s Les nn ez i-- �,r- -i----C..-e— j2..' A-t, `( -e !— Completion of the followincz table may be waived by the Inspector of Wires. No. of Recessed Luminaires INo.of Ceil.-Susp.(Paddle)FansNo•of Total (Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of LuminairesSwimming Pool Above L. In- 0 No.()I Emergency Lignttng grnd. grnd. 'Battery Units No. of Receptacle Outlets INo.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches INo.of Gas Burners No.of Detection and Initiating Devices No.of Ranges INo. of Air Cond. Ton 1 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 KWAL,ocalMunicipal ❑ Connection ❑ er No. of Dryers Heating Appliances KWSecurity Systems:* _J No.of Devices or Equivalent No.of Water No. of Heaters KW No. of Data Wiring: �� Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs INo. of Motors Total HP TeleNo.comof Dmue�nicZcaestionsor Wirinquivag: OTHER: Elent Attach additional derail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 cove , 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 andpenalties o ) ---1 , / fperjury, that the information on this application is true and complete. FIRM NAME: v ) p / e, j" ' `, Licensee: Pr` ( .___;_-___• LIC.NO.: ,_1_,•_„_k '1-' Signature '�". e J...4 ' LIC.NO. (If applicable, exempt in the license number line.) ` c�G—_� 1{ Address: ,0,-,Lin�, �J„d ,,4`)c�u mit 6„)...-C., y`1 Bus.Tel.No.: 1 "Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety"S”License: Alt Lic. No. �� 3��,J ? S -, - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below, I hereby waive this requirement. I am the(check one 0 owner Owner/Agent0 owner's a_ent Signature 0.1 Signature. No. PERMIT FEE: $