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Home My WebLink AboutBLDE-22-007065 . . Commonwealth . of Official Use Only Massachusetts Permit No. BLDE-22-007065 of Is 4 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:6/7/2022 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) 57 GENERAL LAWRENCE RD Owner or Tenant Maryann Marshall Telephone No. Owner's Address 57 GENERAL LAWRENCE RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 e Box) Purpose of Building Utility Authorization , ' Existing Service Amps Volts Overhead 0 Undgrd ■ ;' s New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install service to new garage. Completion of the.following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires 20 No.of Ceil.-Susp.(Paddle)Fans 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 2 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices Heating Local 0 Municipal No.of Dishwashers Space/Area KWConnection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 l0,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 pen-nit 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: Dana K Otis Licensee: Dana K Otis Signature LIC.NO.: 27163 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address: 19C GIDDIAH HILL RD, ORLEANS MA 026534013 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: $50.00 611 163 ,V NO' OA .1 ri ECE ! V JUN 06 2 $ Conan onwfanh of Massackmetts rOfficial Use Only E3UiLuiNG u .' t�. T ,,,,j _t Permit No. G...2Z- 04 By: ' A *�.�:;"Iv �f/„`"""'�ni O��(Ai�fMY%Cf6 Occupancy and Fee Checked ►:_4" BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 INFORMATION) Date: l0 - City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned givers noti/�—othis or her intention to perform the elec 'cal work described below. Location(Street&Number) , 5-7 ( il e%r� GN/' c r /�- . Owner or Tenant �olr e,//9h4 d may'' t/I �/f�4 LL, Telephone No. Owner's Address l ..5+ . Is this permit in conjunction with a building permit? Yes ❑ No,,[ (Check Appropriate Box) Purpose of Building 6.49r'f¢p,i Utility Authorization No. '//�7t y Existing Service Amps c�!! / Volts Overhead 0 Undgrd❑ No.of Meters New Service "A Op Amps /26 /,2yv Volts Overhead Undgrd❑ No.of Meters Number of Feeders and Amlarcity 92; S el) Location and Nature of Proposed Electrical ork: yeti;Kr ok, i,- Pt v4-k LI - (/ Completion of thefollowtngtabte may be waived by the Inspector of Wires. tb No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of otal T/ o�6 Transformers KVA KN.. • No.of Luminaire Outlets 02 d No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of.Emergency Limingg and. ❑ grad. ❑ Battery Units No.of Receptacle Outlets A No.of 00 Burners FIRE ALARMS No.of Zones No.of Switches No.o[Gas Burners 'No.of Detection and 4. Initiating Devices It! No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons . KW_ 'No.of Self-Contained Totals: ' `.'.. Detection/Alertint�Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection 0 other No.of Dryers Heating Appliances KW Security a ofDevices or Equivalent No.of Water , No.of No.of Data Wiring: Hasten 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 if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Wo (Wheat required by municipal policy.) Work to Start: o —(, -,22 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 ins ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of peAwy,thf the information on this application is true and complete. FIRM NAME: 0009 OA>_ r C-Ler 's'IC Art. LIC.NO.: ,-A7/63 Licensee: 0/444 01 Signature_...Sn ��- C LIC.NO.: (Ifgpplicabkj enter••efirem�pp�' in t e lit number line.) Bus.TeL No.:77t12`2_-640 Address:!yt 6tGt�i AA' , fe l prLA•�,L /h.e2 6)2�� Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Departure&of Paidic Safety"S"License: 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. I PERMIT FEE:$ ,51)