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Home My WebLink AboutBLDE-23-000601 Commonwealth of Official Use Only . 11% Massachusetts Permit No. BLDE 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:8/4/2022 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) 4 THORNTON BROOK RD Owner or Tenant MIKE SHEA Telephone No. Owner's Address 4 THORNTON BROOK RD,WEST YARMOUTH, MA 02673 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 ❑ 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: Pool 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 Abovegrnd. ❑ In-grnd. B❑ No.ofatteryU Emnitsergency Lighting 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. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Connection Municipal 0 Other: 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 Signs 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Joseph P Rose Licensee: Joseph P Rose Signature LIC.NO.: 12339 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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: $65.00 Ilzu\teicatkA)iii 7; G(24.)1 A 0 I A/6- GIS-172/4 it c- Pw C0/3(- � RECI...YE ® AUG O 4 202 ' each of Maddarlsadoth. Official Use Only , f� f';CD NG DEPART 4 ' , al° •}im Jervicse Permit No. "'Z3 '(� ( "''"_'` = ' 'EVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) Q APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M ).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4//,/ . O? . City or Town of: YARMOUTH To the Insc r of Wires: By this application the undersigned gives fofice ofhis or her intention to perform the ec 'cal work descri below. Location(Street&Number) LA �cl r'I'c--cm �C OC)k we-` t�G-eymg�1 Owner or Tenant iM IL. �),1G c 1` I' Owner's Address• Telephone No. • Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check 1 Purpose of Building Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead❑ . Undgrd❑ No.of Meters J DiszAcExist Amps / Volts Overhead El Undgrd❑ No.of Meters Number of Faders and Ampacity Location and Nature�f Electrical Work: r m i a,-.t1 be i --L � ,Y-._P ?061 w ,� Completion of the following table may be waived by the Inspector of lyres. No.of Recessed Luminaires Na of CdL-Snap•(Paddle)Fans "No.of Transformers KoVtalp CI. No.of Luminaire Outlets No.of Hot Tubs Generators KVA tic No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting '� No.of Receptacle Outlets mod' mod' ❑ Battery Units Na of Oil Burners FIRE ALARMS 'No.of Zones V'sNo.of Switches 4. No.of Gas Burners 'No.of Detection and t 1.1 Na of RangesInitiating Devices No.i Air Cond. Total No.of Alerting Devices Tons Na of Waste DisposersHeat Pump'Number!Tons KW No.of Self-Contained Totals: ��"�' "'"" Detection/Akrtin Devices No.of Dishwashers Space/Area Heating KW Local❑ laIIIn No.of Connection 0 OtherN Dryers Heating Appliances KW Security Systems:* Na of Water KW No.of Na of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.o Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W � OTHER: Na of Devices or Equiva ent Estimated Value of Electrical Work: Attach additional detail tf desired,or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) 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 .1 BOND 0 OTHER 0 (Specify:) I certify,under the pains and pe ofpeyury,that the information on this application is true and complete FIRM NAME: e. LIC.NO.: Licensee: � -'P - r (iej..-Sit./t% P LIC.NO.Ja of (If applicablehgter"exempt"to he licviinumber l e Address: t >c- ) . W,WA - 0�,0 /i Bus.TeL No.• �- 5�6 *Per M.G.L.c. 147,s.57-61,sakkurity work requires Department of Public Safety"S"License: AIL L c.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 III owner ■ owner's •±ent. SOw attire ent Telephone No. PERMIT FEE:$ c7Lkts cfrks 24)crk 4ig as /Ai tOkyv 146-1115.-g n S A ,ema e ?ANN, Pqipe.42 , C04) ,grt6te rt m5