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Home My WebLink AboutBLDE-22-004677 Commonwealth of Official Use Only 11 Massachusetts Permit No. BLDE-22-004677 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:2/24/2022 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. Girl 69 Location(Street&Number) 37 SHELBURNE RD Owner or Tenant VERMETTE JOHN L Telephone No. Owner's Address VERMETTE HEATHERLEE,37 SHELBURNE RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 home following fire. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- p 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 Initiatine Devices No.of Ranges No.of Air Cond. To No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices Heating Local 0 Municipal No.of Dishwashers Space/Area KWConnection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: THOMAS P SULLIVAN LIC.NO.: 18182 Licensee: Thomas P Sullivan Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:71 WAQUOIT RD, COTUIT MA 026353517 *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: $75.00I p_46,cpti ---5 (( f1 / 4/fa g llgi7vw -e }iPt--c-- (4--s- �. 7 • aCOlM R E C °4 ■-. _4 r E IV ED "� FEB 23 20� M a eec/wde ofyciaus eDaly Permit N - — ��eg ; _ - 3ARl " rtf o`cur Serfdom,, ` ILDING uc Z.__- -.i... - - - • VENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM E An work to be performed in accordance with the Massachusetts Electrical CodeLECTRICAL�WORK L6 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2 City or Town of: �3 Z a this YARMOUTH To the Inspector of Wires: EY application the undersigned gives notice of his or her intention to t.,ocation(Street&Number) perform the electrical work described below. sh perform _� Owner or Tenant -�._ Owner's Address Telephone No. ~r Is the permit in conjunction with a building permit? Yes [-}-- No �erpose of Building � � ❑ (Check Appropriate Boz) Utility Authorization No. Existing Service :naps _ /__Volts Overhead 141, ing Ser 0 Undgrd 0 No.of Meterscri _ mps / Volts Overhead❑ Ued rd Number of Feeders and Ampaclty g ❑ No,of Meters r-- E 1ocadon and Nature of Proposed Electrical Work: F. ■ ^I`C7a A 3+c n it s C. f— Gf.?tie F 1 Coin.le So a the ollowtm table m, be waived b the I , tor o Wir cv To.of Recessed Luminaires Na of Cell.-Susp.(Paddle)Fans 'o..o o� es. Na otlLumivalre Outlets No. KVA Na of Hot Tubs Generators KVA -I' Na of Luminaires Swimming Pool 've 'o.a Units ea ; o.of Receptacle Outletsd' ❑ 'An-d• ❑ Butte Unitgs ng ,1` Na ofOU Burners FIRE ALARMS No.of Zones r.of Switches No.of Gas.Burners `a o rl i 1 o.+ of Ranges Initladn Devices No.of Air Coed. o' Tons No.of Alerting Devices o.of Waste Deposers •pT�p 'um,yr m Dos _ '. :.' ._ 'o.o ' on a , No.of Dishwashers ._.. Detection/Alert's Devices Space/Area Heating KW Local❑ un p No.of Dryers Heating Appliances KW Connection 0 OtOther`,o.o Heaters KW `o.o `o,o Laces Na of D or E divalent S, ns Ballasts Wiring: No.Hydremassage Bathtubs Na of Devices or ' ,nivalent No.of Motors Total HP e ecommun ; ,ns T OTHER: Na of Devices or ' ,divalent Estimated Value of lectrical Work: l f�t (f _ Attach additional detail"desired,or as required by the Inspector of Wires. Work to Start:02 �,� ----- (When requiredby municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAG : 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 Q -BOND 0 OTHER I certify,under the pains and penalties o pe0 (Specify:) FIRM NAME. ,that the Informedn on!h i o Ls true and complete i /-07 Licensee: LIC.NO.: (I a )!cable enter Signature LIC.NO.: j pp exempt"in the r. e number l et Address: G 2 6 e r- Bns.Tel.No.• �'— •Per M.G.L.c. 147,s.57 security work requires Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aw t of Public Safety"S"License: Lic.No. YBymy signature below,I h waive tthis rrequirement tl am the(ch(check one e liability insurance ow co owner's cd b law. 11 II Owner/Agent Signature Telephone No. PERMIT FEE:$