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Home My WebLink AboutBLDE-22-006831 A Commonwealth of official Use Only Ems, Massachusetts Permit No. BLDE-22-006831 `�— 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:5/24/2022 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) 125 THACHER SHORE RD Owner or Tenant FONTS CARLOS A Telephone No. Owner's Address 125 THACHER SHORE RD,YARMOUTH PORT, MA 02675-1129 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: Wiring of pool equipment. 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. 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. 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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. Egitnated 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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 5 JANS PATH, HARWICH MA 026452458 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:$50.00 ottlf-te44c1\15- come-pa/44 .t5 ()LAI) Fen 6 1 Srakt-- •=;y1s5-2:11/411 t ' ?/v% (614° 21:4-1---CF6 4.12)0/ O, Evr' (Q12NEeku A /ow- oe) Commonwealth of Massachusetts Official Use Only •-; I _" i t Permit No. -IL2-.b63L . ,ei Department of Fire Services '',= Occupancy and Fee Checked % f i=t' BOARD OF FIRE PREVENTION REGULATIONS (Rev.9/051 4 4r,..0.3,- (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 TYP ALL INFORMATION) Date: City or Town of: / I (Y\ To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform theitnelectrical work described below. Location(Street&Number 125 I iya )11--)a°_,r +c�- Owner or Tenant LA,(((X.) 1-7}(T±5 Telephone No.-77t-t,,20 -3g-6-6— Owner's ; -6--Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. q Existing Servic 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: (A)t I A ,eq 0lioIyifVT/— Completion ICompletion of the following table may be waived by the Inspector of Wires. Tot No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tof KVA TrNoansformers KVA No.of Luminaire Outlets . No.of Hot Tubs Generators KVA Above In- 0 o.of Emergency Lighting No.of Luminaires Swimming Pool grnd. � l grnd. Batter Units No.of Receptacle Outlets No.of Oil BurnersFIoRo ii eAR oS aid No. of Zones No.of Switches No.of Gas Burners Initiatin Devices No.of Ranges No.of Air Cond. Tons 'No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW o.of Self-Contained p Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area HeatirgKW Local❑ Municipal 0 Other P Connection No.of Dryers Heating Appliances KW ecurity Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Eciuivaglent ommuni No.Hydromassage Bathtubs No.of Motors Total HP Tel No.of Devic sons or E,ivalent 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:51 31a ' 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 proof of same to the permit issuing office. CHECK ONE: INSURANCE ) BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the it formation on this application is true and complete. FIRM NAME:PA4 NE ell:el pm.) I NC., LIC.NO.:53OZ4-E, Licensee: 711E2 1E2 W . INE Signature 44;46--- LIC.NO.:12.•' — A (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: a ►. Address: P O. 13OX t'D1'1 SOFT H ti lett. tL n , M OZ�O�D Alt.Tel.No: I' �i+L *Security System Contractor License required for this work;if applicable,enter the license number here: 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 Telephone No._ PERMIT FEE:$ Signature