HomeMy WebLinkAboutBLDE-22-000963 Commonwealth of Official Use Only
(fi. Massachusetts Permit No. BLDE-22-000963
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:8/19/2021
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform tl c ectrical wosJr4Tscribed below.
Location(Street&Number) 1014 ROUTE 6A kl( ri
Owner or Tenant Telephone No.
Owner's Address - -Ca ' RS _1' • ■ ' 1-•- -` ' • - "n•..--- - ' _•. 12
Is this permit in conjunction with a builOing permit? Yes 0 No 0 Box)
Purpose of Building Utility Authorization
Existing Service Amps Volts Overhead 0 Undgrd e:., n.
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: New residence.
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 0 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 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:
Licensee: Daniel Deleo Signature LIC.NO.: 22724
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:97 Hubbard Pond Road, New Ipswich N.H. 03071 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: $180.00
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AUG19 !.. ,,I Commonweal of 1//aaaachuesife ficial Use Only
-':''at;-.r=1;t Permit No.
B U I-U I fV U t . ,►IF .eparimsnt o/gips Srvicse
By I �? Occupancy and Fee Checked
•'' ' BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code ME ) 52 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /l C 2-4
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to pert �the/e�le'ctr' al work described below.
Location(Street&Number) [014[0 l 4 r i 6vt , K.T U/ A QQ
Owner or Tenant 'Ok n Ca I tat hen_ Telephone No. ld L` /6 C
{ tw3Z
C1'Owner's Address i ' (`-1 /1 G1 aA 5'i'"
Is this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No. 603 32. 0_,
Existing Service j--- Amps r I✓Volts Overhead❑ Undgrd
� � �^ g ❑ No.of Meters it
e Ct
New Service Amps C G0 / ZPIOVolts Overhead❑ Undgrd g ® No.of Meters
Number of Feeders and Ampacity ` VC,afrtp
Ip`ps
Location and Nature f Proed Electrical Work: Lai- ;8,e b
° /veil/ o��Sf-itc,710/1 t oitq S 1 vS e. T S r
;.
o Completion of the following table may be waived by the Invector of Wires.
t No.of Recessed Laminate es No.of Ceil.-Soap.(Paddle)Fans No.of Total
`•'f Transformers KVA
I-7,1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA
r:\
No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting
grnd. grnd. 0 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
Initiating Devices
No.of Ranges No.of Air Cond. Tons
No.of Alerting Devices
No.of Waste Disposers Heat Pump 1 amber Tons KW No.of Self-Contained
Totals: """""""'"""" Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Locel❑ Municipal
Connection ❑ Other
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 ri_Elpctric I Work: K\ (When required by municipal policy.)
Work to Start: to l [et Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERA E: niess 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 c,_ov,,�e ge is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE Lo7 BOND ❑ OTHER 0 (Specify:)
I certify,under the ains and penalties ofperjury,that the information on this application is true and complete.
FIRM NAME: Von ce0
��I ( CC C.NO.:
Licensee• Signature LIC.NO. 4,�Z7
Of applicable entter"exempt"in the license num er line.)
Address: 7, W tiInd �, A.k -C �l� / O r/1 Bus.Tel.No.:_�_
*Per M.G.L.c. 147,s.57-61,security work requires Departmen of Public Safety"S"License:iAlt.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)0 owner 0 owner's agent.
Owner/Agent
I PERMIT FEE:$ /19
Signature Telephone No.
'o�'YAR- TOWN OF YARMOUTH
4,1 • t ---\ BUILDING DEPARTMENT
o . _ y 1146 Route 28, South Yarmouth, MA 02664
,mac, 508-398-2231 ext. 1263 Fax 508-398-0836
K. Elliott, Inspector of Wires
kelliott(a varmouth.ma.us
March 3,2022
Daniel Deleo
97 Hubbard Pond Road
New Ipswich, N.H. 03071
Location: John Callahan, 1014 Route 6A,Yarmouth Port
Permit Number: BLDE-22-000963
Dear Dan,
The above noted location inspection failed to pass for the reason(s) listed.
Article 314-20 No more than 'A" set
back. (Box extensions required)
Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and
advise when the corrections have been made and when access may be gained,to the property,
for the re-inspection.
If you have any questions please do not hesitate to contact me.
Sincerely,
Town of Yarmouth, Building Department
K. Elliott,
Inspector of Wires