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Home My WebLink AboutBLDE-22-005729 Commonwealth of Official Use Only Permit No. BLDE-22-005729 fi-, i Massachusetts 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:4/7/2022 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) 2 DUCK POND RD elp_771��-7 Lf Oi Owner or Tenant MORLEY DAVID A Telephone o. Owner's Address MORLEY LEANNA M,2 DUCK POND 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 150 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace&upgrade 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 Initiative 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts +�. Data Wiring: Sinus 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 :) I certify,under the pains and penalties ofperjury,that the information on this application istrue and complete. FIRM NAME: Ray W Bombardier Licensee: Ray W Bombardier Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 33621 Address:PO BOX 2443, MASHPEE MA 026498443 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 d 81 . Lk......... Commonwealth 49 n;.4o.L Official Use Only - �, 2)epartment o/ ire Serviced Permit No. ZZ f{-G Occupancy and Fee Checked >r� �, 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( C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �(Q/14> City or Town of: j $► To the Ins ector of Wires: tip, By this application the undersigned,gt s notice of his or her intention to perform the electrical work described below. Location(Street&Number) L (>j - PO (J 1 Map Parcel# Owner or Tenant C)4v (/p- Telephone No.Sag-7)?,)4E,3� Q Owner's Address $64. W'r Is this permit in conjunction with a building permit? Yes 0 No (Check Purposec......, 2 Appropriate Box) 4 of Building Utility Authorization No. Existing Service/ ' Amps Olt,/ a'}!b Volts Overhead Undg rd 0 No.of Meters New Service ?,op Amps t /a1 VO Volts Overhead r21 Undgrd g 0 No.of Meters e Number of Feeders and Ampacity 3 a,00 ( Location and Nature of Proposed Electrical Work: J i-t Le lr'O °a v D ro LA,. n -cy e�L t s7ZN+ t 5-0 �9 5� .. Ni 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 0In- ❑ No.of Emergency Lighting grad. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones e No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number To KW No.of Self-Contained - = Totals:I M'ns Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other 3 No.of Dryers Heating Appliances K,`, Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Data Wiring: Heaters 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 desiret4 or as required by the Inspector of Wires. Estimated Value of El trical Work: )dp 0 (When required by municipal policy.) Work to Start: 5 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO 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 M BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties o 'e u that the information on this application is true and complete FIRM NAME:RA q90,'t, it=t..e 1€C-TCIAC I .3 Licensee: LIC.NO.:l `�j 3 fad l Signature9,,4,,01 2-yr,64+1 ,e "JLIC.NO.: (If applicable,enter"exempt"in the license number line.) Address: �j toV I wry l:' ►1 4?).Cri-f!� Bus.Tel.No.• * C)t77 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public afety"S"License: Alt.Lic.No. �t` OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑ownerver■ owne'sa allylent. Owner/Agent Signature Telephone No. PERMIT be$ p - *IMPORTANT:A separate permit is required for the installation of smoke detectors.Fire Alarm inspections are performed by the FD having jurisdiction: r vmtAT- .ter- c{itift Act -COm