BLDE-22-000403 ent
Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-22-000403
lit!rBOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/071
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:7/22/2021
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 below.
Location(Street&Number) 2 HALYARD RD
Owner or Tenant Robert Feinstein Telephone No.
Owner's Address 2 HALYARD RD,YARMOUTH PORT, MA 02675
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 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wiring for two split A/C's&receptacles as needed.
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 Arnd e 0 In- ❑ No.of Emergency Lighting
Ag
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. 2 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 Siens 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: EUGENE J EMERSON
Licensee: Eugene J Emerson Signature LIC.NO.: 20136
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:PO BOX 1122, ORLEANS MA 026531122 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 I
a's 7/z---,i-zi
1
A emeawairegii 4//l needs A-fI, Official Use Only -
• .Ue wwa w of e�.JIN Jean,' Penult No. r-:--22--® U
r BOARD OF FIRE PREVENTIONOccupancy and Fee Checked
t� _ REGULATIONS [Rev.1/17] (leave blanit)
•
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
-d► MI work to be pertemed in aeeoedaan with the Maisackieette Electrical Coda(MEC).527 CMR 12.00
1 (PLEASE PRINT IN INK OR TYPE ALL INFORMlTTON) Date: 7/21/2021
City or Town of: Yarmouth
Bythis application the uadersiTo the Inspector of Wires:
P gives notice of bis or her to perform the electrical wont described below.
Location(Street&Number) 2 Halyard Rd
el Ower er Tenant Robert Feinstein Telephone No.
2 i Owner's Address
O Is thIs permit In eenj.nxttss with a
c.
Home Yes 0 No (Cheek Appropriate Box)
),c Purpose of Building Utility Minimisation No.
F Misfit's Service 200 Amps 120/ 240 Vets Overhead E Undgrd 0 Na of Meters 1
fillRilsoist
V A®pe / Volts Overhead 0 Undgrd❑ No.et Meters
Ory INumber of Feeders and Amp__
I.orate.and Native ofPnpasedRiartriedWarlc Wire 2 outside condensers and 4 indoor wall units
., add wp gfci outlet when needed
Completion of thefolknvinkiable apv be tactical by the heintate of f ee.
of Total
No.of Reamed Lsad.iss No.of Ce48.sp.(Pedal)Pens TTrasuEsmimes KVA
No.of Luminaire Oedsb No.of Het Tabs Generators KVA
No.of I..randna swhe.tig reit 0 ❑ no.st u� y using
No.of Reeeptade Ovate No.KOK Bonen FIRE ALARMS ]No.of Zeno
No.of 8wikhss Na of Gas gapsNo.of Deloction and
11,'° No.of Air Gad. Total
Tens 'No.of Alerting Devices
No.of Wane Disposers HestPseopT�
Todl� ar8e]FCeols�ed
l' '
N..of Dldewadtes Spate/Area Heating KW Local 0_f , 0 Otho'
NDryers Elwin Annum KW
ooff W KW 'N of i or vale t
Heaters Data%Wing:
Sias. Ballasts No.of , JA.,- or M
No. Bathtubs No.of Motors Total HP T No.of Dovias or
OTHER:
Estimated Value of Electrical Warn Attoch mb&eoaaf detail VdeaNtre(arm regrab�eet by the/artrednr of Km.(When required by municipal policy.)
Wait to Start 7/1 A/7(121 Inspections to be requested in accotde eco with MEC Rule 10,and upon can Iecion.
INSURANCE COVERAGE: Wen waived by the owner,no permit fix the pe$rmtsa of electrical wroth may issue Cutlass
the licensee provides proof of liability insurance including"completed operation"coverage or its suMbaaalteakol.
Tin
undersigned certifies that such coverage is in force,and hes=harked proof of same to the permit issuing office.
CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Spew)
I awe,.osier tie pe as gni powskIss alp that the iegin.ai.vlea ere tkia eppRa ilim it awe and ee.,pr
FIRM NAME: Emerson Electrical Construction I
i• LIC.No.: A20136
eeaeee: Eugene Emerson
(l1 i ..veer" i (-h ��IdC.NO.:E38135
esempe M rise license somber sten_) Bas.TeL No.: 875.5.q A.q 3
Address: PO Box 1122 Orleans. MA. 02653 Attu Tel.No»53601 l 13
'Per M.G.L.c. 147,s.57-61,security work requires
OWNER'S INSURANCE WAIVER: I am think doers�the liability,ublic Safety"S"License: Lic. '
requited by law. By my s;
Agent ! below,I hereby waive this , I am the(cheek one)0 owner n's amt.
Telephone No. I PERMIT FEE:5 50.00 1