The URL can be used to link to this page

Home My WebLink AboutBLDE-23-001820 . _ist A Commonwealth of Official Use Only ' €r ►i, Massachusetts Permit No. BLDE-23-001820 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:10/5/2022 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) 21 MONROE LN Owner or Tenant STEVEN PETLUCK Telephone No. Owner's Address 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC. 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 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Ton 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 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 ❑ 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: Adair Martins Signature LIC.NO.: 23369 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Franklin Avenue, Hyannis MA 02601 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 R (tYigtw a- (citt # 7Jt5-r F ra /r ii . . ,Y r - i_ttetti r1-0 3'0 *. Oit zo , 3=° o 'oaf+ ///aadac tfd Official Use Only mom/ `lf�1�3 J( �/ Permit No, ,,,,,,,3i,„,......qtrviced BOARD OF R: PREVENTION REGULATIONS Occupancy and Fee Checked i jRev.1/07] (leave blank) .: • ,-.,tli: OcYARTMENI . _. _-- -•e.• R 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: I0/05/a a, 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) a) M thtC o Q tm Owner or Tenant J ill Q:4- e k. Owner's Address P Telephone No. -*IS -4. -509 .j Is this permit in conjunction with a building permit? Yes 0 No Er (Check Appropriate Box) Purpose of Building ;es.I adl'Vial Utility Authorization No. Existing Service Amps / Volts Overhead It New Service 0 Undgrd 0 No.of Meters Amps / Volts Overhead 0 Undgrd 0 No.of Meters ii Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: lag_-t.v;rKcal (Ann,o`ere_ t r4C wool eA 06 ki- Lb%v. Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans No.of al n Na of Hot T No.of Luminaire Outlets eubs Generators KVA KVA ^¢." No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting Battery Units ''i No.of Receptaclead' °d• ❑ Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and 114 No.of Ranges Initiating Devices g No.o'Air Cond. TO�I No.of Alerting Devices Tons Na of Waste Disposers Heat Pump Number Tons I 1-KW No.of Self-Contained ' Totals:I'"� "I "" " ' _ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ 1�nielpal No.of Dryers Connection ❑ �' rY Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters No.of KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunkat(na Wiring. OTHER: No.of Devices or Equivalent Attach additional detail Ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4 221)0 (When required by municipal Work to Start: l oaf 22 Inspectionspule 10 COVERAGEin: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND 0 OTHER 0 (Specify:) I certify,under the pains and nalties of petju ,that the information on this application is true and complete FIRM NAME. Licensee: LIC.NO.: 3 �—,9- (fapp t- Signature LIC.NO.:�6�$ ! see: a enter"exempt"in the license number line.) Address: 0`2$ �fo.n kL;n Ave a...n:g M0 6� ) TeL No Bus.TeL No.• - IS, *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 N owner ■ owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$