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Home My WebLink AboutBLDE-22-000336 Commonwealth of Official Use Only ,E Massachusetts Permit No. BLDE-22-000336 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:7/20/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described b�°0� Location(Street&Number) 9 Vernon St ` p Owner or Tenant MICHELLE GRAVELINE/GRAVELINE TRUST Telephone No. � Owner's Address 9 VERNON ST,WEST YARMOUTH, MA 02673 PO?'r' i L • Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A pro riate Box Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary service. 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 ❑ 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 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: Shawn Micheal Ricard Signature LIC.NO.: 22895 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7748012921 Address:27 Baywood Drive, Orleans MA 02653 Alt.Tel.No.: 9788157031 *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:$50.00 `c ecce( . g4Conu onwaatt/e o`KA:lacked*111 Official Use Only _VR. 't :1 �[Jsivartmsnf o�,}ins Serviced Permit No. ,�`- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '? 11421 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) q ye/no 4 Owner or Tenant G rt>,tk i n Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building R•t$ic9e„k,g-,J Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service /0 O Amps /et) /o)`K' Volts Overheads Undgrd ❑ No.of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: e rvn 5c.0 c,c vc vl Completion of the followinxtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)Fans No.of Total `•'' Transformers KVA C.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA f" 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 : TotaInitiating Devices No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number[Tons {KW No.of Self-Contained Totals: ""' """' """' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LcealMunicipal 0 Connection 0 °ther No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: '7A4h/ 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penglties of perjury,that the information on this application is true and complete.'k $15 FIRM NAME: ,.,� t t t c„r d g-al A LIC.NO.: Licensee: a '9-,tc."ft d Signature s (If-applicable enter"exempt"in the lie nnumber line.) LIC.NO.:��ac(S/ Address: 0 770e JS(, c�f,,,� Bus.Tel.No.:a7Xr .. *Per M.G.L.c 147 s 57-61,security work requires Department of Public Safety"S"License: Alt.Lic.No., OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent owner ■ owner's a.ent. Signature Telephone No. PERMIT FEE:$