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Home My WebLink AboutBLDE-22-007118 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-007118 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:6/8/2022 City or Town of YARMOUTH To the Inspector of!fires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 20 CAPT BLOUNT RD Owner or Tenant CHRISTIANSEN RODGER A Telephone No. Owner's Address CHRISTIANSEN SUSAN T, 20 CAPT BLOUNT RD, SOUTH YARMOUTH, MA 02664 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 ❑ 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 generator Completion of the f011owing table may he 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 1 KVA No.of Luminaires Swimming Pool Above ❑ in- ❑ No.of Emergency Lighting grad. grad. 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/Alerting 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 Signs 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 ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FiRM NAME: JOSEPH P ROSE Licensee: Joseph P Rose Signature LiC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd, West Yarmouth MA 026733559 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $200.00 �"� -cam(e(q(27✓ C� � � VVI J2�-� t Nucceac t - 0914 c7117 1 ( ,mnwnweaa e`Mouselussdis Official Use Only " .ft c� n Permit No. 7(1 b a+' 2epart ural o`.}irr&rvrces fYBOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1ro7� (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: (n I C6 j, ,p'zCity or Town of: YARMOUTH To the Inspect° of Wires: By this application the undersigned gives- ce ofhis or her intentionorm the electrical work described below. Location(Street Si Number) ,-n 156 r 12-7-1, Owner or Tenant ROA. S--1.lQ in S C le> Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No,b (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Locationand Nature of Proposed Electrical Work: 4...eb r cG tit?sr, c. gGn c.Ca 1Qr r m f Wry! ''rU-nS'<C 21Ai1 l't In nCompletion of thefollOwing$ble rep be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Cdi.-Sap.(Paddle)Fans of KVA Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators / KVA7 j No.of Luminaires Swimming Poot Above In- No.of Emergency Lighting fid- ❑ grad ❑ 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 4 Initiating Devices I t,! No.of Ranges No.aAir Cond. Tota No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ` -"`- """. Detection/ Devices No.of Dishwashers Space/Area Heating KW Local❑ Mun 0 Other Cyonnectioa No.of Dryers Heating Appliances KW NSecurity Devkee or Equivalent No.of Water ters KW No.of No.of Data Wiring: Signs Ballasts No.oevkor Equivalent _ No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNoW Equivalent OTHER: Attach additional detail tf desired,oras 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEND 0 OTHER 0 (Specitjr:) I certify,under the pains an pe ofperjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: .. (�,c.91.\ `?. `bt2{ signature 4`iarlAz. J VIII", LIC.NO.: ag 61 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.• 7 S'a 6 Address: 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 doer not have the liability insurance coverage normally required by law. By my signature below,l hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Signature Owner/Agent1 Telephone No. (PERMIT FEE:$