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Home My WebLink AboutBLDE-22-006893 f �� Commonwealth of Official Use Only fin Massachusetts Permit No. BLDE-22-006893 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:5/30/2022 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) 141 HIGHBANK RD Owner or Tenant Steven Sullo Telephone No. Owner's Address 141 HIGHBANK RD, SOUTH YARMOUTH, MA 02664 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 basement. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 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 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 ❑ Other: Connection No.of Dryers. Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent 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: Roger Poitras Licensee: Roger Poitras Signature LIC.NO.: 14319 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 176, ROCHESTER MA 027700176 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 i 7/1e/ crrt �.QFL1€-6.a(t/t of 1 .Fassact�ku ett,} Official Use Only JN Permit No. ZZ (� = 3 � = ; Department of Fire Services MAY .=� q ' L_ ', BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked BUILDING D:�..to MENT [Rev.9/OS] (leave blank) By: ATION 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: t . r— .d ) 1, City or Town of: /el-A M o v i 4 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) / ill f /4 /GI/ l34...fi< /Z O. Owner or Tenant 5 T_ ic. j S u 1.-L 0 Telephone No. Owner's Address / 44 i tt t G 1/ 6 a,v,, A d Is this permit in conjunction with a building permit? Yes 1 i" No E (Check Appropriate Box) Purpose of Building / Si S toA+✓G Utility Authorization No. Existing Service a p p Amps /da /4 CIQVolts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead n Undgrd ❑ No.of Meters Number of Feeders and Ampacity /—a D A. e 3 —/S./n F, A-F.r- c Location and Nature of Proposed Electrical Work: W 1 R c_ Fi ry t SN=0 d4.5 G.r.•`C.0 7- Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires c No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA • No.of Luminaire Outlets C, No.of Hot Tubs Generators . KVA No.of Luminaires C Swimming Pool Above ❑ In- 1-7 �N o. grnd. of Emergency Lighting grnd. Battery Units - No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS iNo.of Zones No.of Switches l' No.of Gas Burners No.of Detection and Initiating Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 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 Connection � Other No.of Dryers Heating Appliances KW Security Systems:* _ v- No.of Devices or Equivalent No.of Water Heaters KW •No.of No.of • Data-Wiring: -.--..>- 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 desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 07 op o, o O (When required by municipal policy.) Work to Start: 7-3.-/_a p D'� 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 [OND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: k , P, E L�e_ re i G— D . _L1 C.. LIC.NO.: / 9 31 9.4 Licensee: R o 6 c t Po i r,.4S Signature( / / L 9 , LIC.NO.: _t 3/9 (If applicable tenter"exempt"in the license number line.) Bus.Tel.No.: d -7,�3- et'37 Address: I,D. 6 O X / 7 C /o e f-F c 5 Tell- in A-- D`7`77 7 O Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: 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 Signature Telephone No. PERMIT FEE: $ 7S,OO I