HomeMy WebLinkAboutBLDE-21-03623/ Official Use Only
or Commonwealth of
..1-. i Massachusetts Permit No. BLDE-21-003623
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: Inspector20
of Wires:
City or Town of: YARMOUTH
By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.
Location(Street&Number) 29 SCALLOP RD
Owner or Tenant Michael Sweat Telephone No.
Owner's Address
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 400 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 Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans TransformersKVA
No.of Luminaire Outlets
No.of Hot Tubs Generators s,R i ' •� KVA
Above
In- CINo.of Emergency ' htkdg .
No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units tf'
No.of Receptacle Outlets No.of Oil Burners FIRE ALARM of ((Y�`ppes . z
-at- N.
No.of Detec ' tyjan 09
No.of Switches No.of Gas Burners Initiating De
1
No.of Air Cond. Total No.of Alerting Demes - '` %%
No.of Ranges Tons
\
Heat Pump I Number I Tons I KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alerting Devices ,
Local ❑ Municipal ❑ ` ,Other:
No.of Dishwashers Space/Area Heating KW Connection
Security Systems:*
No.of Dryers Heating Appliances KW No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts 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.
requiredmunicipal
Value of Electrical Work: (When b y munici pl p olic
y.
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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.: 22967
Licensee: Jon T Moreau Signature
applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
(If Pp
Address:9 Redberry lane, MARSTONS MILLS Ma 02648 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
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $180.00l
I A /� �/�N / s Official Use Only
onu�sonurea a�ac `--k -3 Co Z3
%" c� Permit No.
•' 2epartineni oPire Serviced
Occupancy and Fee Checked
.Z �a BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
(3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
t....
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 12/29/2020
City or Town of: West 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.
3 Location(Street&Number)29 Scallop Road
Owner or Tenant Michael and Rita Sweat Telephone No.
Owner's Address 131 High Street-Newburyport, MA 01950
a Is this permit in conjunction with a building permit? Yes n No ® (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
C.3.) Existing Service Amps / Volts Overhead n Undgrd n No.of Meters
l.P New Service 400 Amps / Volts Overhead n Undgrd k I No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: New Construction -Whole House with 400 Amp Underground Service
Completion of the followin&table may be waived by the Inspector of Wires.
No.of Total
No.of Recessed Luminaires
No.of Luminaire Outlets
No.of Ceil.-Susp.(Paddle)Fans Transformers KVA
No.of Hot Tubs Generators KVA
Above In- No.of Emergency Lighting
No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiating Devices
Total No.of AlertingDevices
No.of Ranges No.of Air Cond. Tons
Heat Pump I Number I Tons I KW No.of Self-Contained
No.of Waste Disposers Totals: l Detection/Alerting Devices
Municipal
No.of Dishwashers Space/Area Heating KW Local Di Connection ❑ Other
HeatingAppliances KW Security Systems:*
No.of Dryers pp No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
KW
Heaters Signs Ballasts 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: 100,000.00 (When required by municipal policy.)
Work to Start:ASAP 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 ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Coastal Mechanical LIC.NO.:8082
Licensee: Jon Moreau Signature ji,711,,g4a,4,i LIC.NO.:22967
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.:508-737-8747
Address: 21 L Fruean Ave-South Yarmouth,MA 02664 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 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 ❑owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.