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Home My WebLink AboutBLDE-22-001257 #16 Commonwealth of Official Use Only • fi_ Massachusetts Permit No. BLDE-22-001257 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:9/3/2021 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) 610416 HARPOON LN Owner or Tenant GRANELLI KEVIN Telephone No. Owner's Address GRANELLI DEBORAH, P 0 BOX 895, BREWSTER, MA 02631 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: Repairs to septic syste fr _ . 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting 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: WILLIAM F DOUGHERTY Licensee: William F Dougherty Signature LIC.NO.: 13932 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 LOWELL DR, ORLEANS MA 026534841 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 thecheck one)) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 I Pej6zf /Wx ( Oise W/ Sk- r) RECEIVED SEP 0 2 2021 BUIL-DIN ; •.:.:1-,1-C111\11- CO °^{4� r// ac/�uestta Official Use Only .. By -- ! , i Permit No. 7 f! BOARD OF FIRE PREVENTION REGULATIONS7 an ":,-"` 4 [luau.1107d Fee Checked(leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Code E ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: q t 102-1 • City or Town of: YARMOUTH To the 1 pe for of Wires: By this application the undersigned gives notice of his or her in tion to perform the electrical work described below. Location(Street&Number) /6jtff j�y�/M'. Owner or Tenant Pebbi., 1 to lI"" Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No tig (Check Appropriate Box) Purpose of Building ittldh&tvd y ej /►t1 Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of l cal Work: , .L,..�_ ` co-4704 as � f k.e.a .1 .v- ,re. . iht / roper, . exaf,iti iMh, ' Completion ofthefollowingtable may be waived by the/nvecfor of WireY. No.of Recessed Luminaires No.of Cell.-Soap,(paddle)Fans No.of Transformers KToVmAll No.of Luminaire Outlets No.of Hot Tubs . Generators KVA No.o[Laminahes Swimming Poo' Above ❑ In- No.of Emergency Lighting *,:,•_, mid. grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones T No.of Switches No.of Gas Burners 'No.of Detection and I t r Initiating Devices No.of Ranges No.of Air Cond. Tonsi No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1KW No.of Self-Contained Totals:� "�" '�" ".` Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW ❑ Municipal No.ofConnection ❑ um"' Dryers Heating Appliances KW Security Systems:* - No.of Devices or Equivalent No.of Water No.of Heaters KW No.of Data Wiring: Signs Ballasts No.of Device;or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'T elecommuuicatlons Wiring: OTHER: No.of Devices or Equivident Estimated Value of I cal Work: Attach additional detail if desired or as required by the Inspector of Wires. Work to Start: JO/ (When required by municipal policy.) W k to NCE O Inspections to be requested in accordance with MEC Rule 10,and upon completion. RAGE: 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 CI OTHER 0 (Specify:) I certify,under the pains and naldes ofperjury,that the Information on this application Is true and complete FIRM NAME: Licensee; � -�— T LIC.NO.: Licenlicable,enter". pt"int ic e'ri el Signator - 4LIC.NO.: 1z Address: 41_,_,:, 1A-e- fa ,< Bus.Tel.No.:77tt-7 8/ *Per M.G.L.c. 147,s.57-61,security work Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that,the Licensee does not haavesthe liability insurance overage normally— S�required by law. By my signature below,I hereby waive this requirement. I am the(check one R owner ■ owner's a:nt. trv/Agent Telephone No. PERMIT FEE:$