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Home My WebLink AboutBLDE-22-005429 as0Ma' � Commonwealth of Official Use Only t ssachusetts Permit No. BLDE-22-005429 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:3/29/2022 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) 36 WARBLER LN Owner or Tenant Neil St. Pierre Telephone No. Owner's Address 872 GLACIER WAY, SOUTHINGTON,CT 06489 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 3 receptacles& 1 switch in front room. 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiatinc Devices No.of Ranges No.of Air Cond. TotaloNo.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 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Steven E Tullock Licensee: Steven E Tullock Signature LIC.NO.: 20114 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:4 RUTH ST, HARWICH MA 026451674 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 N/p- s/ziy �i (L/A9 N C4 £/2¢ kt (tits :i vAwt L (AJJ a- (1719)).-• RECEIVED AAR 25 2022C nweafth ///addaChi0e116 Official Use Only g;• E . Perm --C. ---'.‘2 --CIA 7---7it it No.--Y= `F __ _- ---. _- _ Jp alo1}iro&paced r 1 RTM I Occupancy and Fee Checked ked'' ±f : _•' =•i_i' "' 'REVNTION REGULATIONS [Rey?14024 _(feere-bank)> ,APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code EC),52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g 5 eo e e, City or Town of: YARMOUTH To the Inspector Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work describe below. � Location(Street&Number) 3 6 'e f �. LA t A)€ W S'- '��k 2-P ) Owner or Tenant Ni-l L '- � —Q Telephone No. Owner's Address S A',,,t Is this permit in conjunction with a building permit? Yes 'J No ❑ (Check Appropria a Box) Purpose of Building R E S It)' Fv'AA-L Utility Authorization No. N� 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: l) I t C 3) P t J&3 4 N D (j) 5sCTCD'1 c Pczot,sv Rc)o1-( Ort Completion of the following table may be waived by the Ins ector of Wires. \A U. No.of Recessed Luminaires No.of Cell.-Sas No.of Total r+•fp.(Paddle)Fans Transformers KVA �t No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,t= 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and otal i Initiating Devices No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number KW °No.of Self-Contained Totals:I Tons {__.._....__.. Detection/Alerttnt_Devices No.of Dishwashers Space/Area Heating KW LocalMonnectiounicipal 0 Cn ❑ °ther No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrial Work: (When required by municipal policy.) Work to Start: 3 2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CORA E: Unless waived by the owner,no permit for the performance of electrical work may the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.Th undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ezi1 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: ,,j\t,\)E —rt',,t(QCT LIC.NO.: 2O t 14-A Licensee: j \I J t l CC.Y.Signature ..-4--1"-=----�----�1"-‘2"2�- LIC.NO.: (If applicable,ente 'exempt"in�i a license number line.) Address: ' (4.‘St ‘t �� cwt Qt., Bus.Tel.No.:fig~e02—2j`--12Io el.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$