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Home My WebLink AboutBLDE-22-007141 r Commonwealth of Official Use Only 43 Massachusetts Permit No. BLDE-22-007141 BOARD OF FIRM PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/071 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:6/9/2022 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) 484 WILLOW ST Owner or Tenant EVERSOURCE Telephone No Owner's Address Is this permit in conjunction with a building permit? Yes ❑ 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: Install horn/strobe devices Completion of the.following table may r be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total - 'Pransfornrers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- ElNo.of Emergency Lighting grnd. grad. 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 Initiating Devices No.-of Ranges No.of Air Cond. Total No.of Alerting Devices 2 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 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 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((desired, or as required hr 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. 'C(C)S CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certifjr, ander the pains and penalties ofper%ury,that the Win-motion on this application is true and complete. - clout, -. c24) j FIRM NAME: TIMOTHY 0 ROCK Licensee: Timothy 0 Rock Signature LIC.NO.: 21846 (Ifapplk'ahit!.enter "ca-empt"in the license number/nrer Bus,Tel.No.: Address: 23 Monroe St, Westport MA 027902308 Alt.Tel.No.: *Per M.U.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: $115.00 12,13041 le I re/r1 - I 12A41t- 9`121•/7), r6 0-P-Anit5- loan- 7//47 - 1 Pi rr Pevcnil 4- ,...."'"+^•r"` Commonwealth o/?aieac�iuo¢tfa fficial U my }P * ft �-2-l I Li R �, - c'� c7 Permit No. = y 2eparfinent of-tire Jervicea i BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �'.,,,:�` [Rev. 1/07] (leave blank) 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 IE ALL INFORMATIOA9 Date: � jP,a O a City or Town of: E, p0 T77 To the Inspector of Wires: By this application the undersigned gives notice o isorher intention to perform the electrical work described below. Location(Street&Number) tiff(,6 L'U `/O y/Ft yy,D U J //t 14 e)..0 7, Owner or Tenant , 1/r 1'Z S 0 U/2 � Telephone No. Owner's Address P. 60X ??D, M912TrDA2) Lt r / /D �f Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check A — -_---- _- ppropriate Box) Purpose of Building t 0 _ �!4'f2/ GAFL Utility Authorization No. Existing Service 010 6 6 Amps /a n/ ae'Volts Overhead❑ Undgrd Q- No.of Meters / New Service Amps /-- Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity //)/4 Location and Nature of Proposed Electrical Work: %tJS 72q- (_) / le,t/ISTAO g S l Completion of the foltowin tr to � � ; a No.of Recessed Luminaires No.ofCeil.-Sus . N p (Paddle)Fans No.afLuminaire Outlets No.of Hot Tubs G r ` - No.of Luminaires swimmingPool Above In- N . grad. ❑ grad. ❑ B z,,. No.of Receptacle Outlets No.of Oil Burners FI , No.of Switches No.of Gas Burners N 'I'otaL _, ',- ' , _ No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers heat Pump Number Tons [KW No.of Self-Contained - Totals: '' ' I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection. ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters . Data Wirings' � Signs Ballasts No.of Devices or Equivalent Na.H dramassa a Bathtubs Y g No.of Motors Total le ui OTHER: • No.of Devices or Equivalent 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: 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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties o f perjury,that the informationon this application is true and compCete. FIRMNAME:Pncic tL,ECTe_,i C '>f3- CovY) TA)C. Licensee: f rrl 0 LIC.NO.: �D gip? 9-/ T j n e i)C Signature 7`n / -_ LIC.NO.: <9 /94/6 4 (If applicable,eater"exempt'in the license number line.) Address: �l A G.L Z6 i E S f(J �y) D FD/e3 Bus.Tel No.: 5 94-5- 61 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety License: Alt.Tel. ASS- I S 9 "S" COda3r, 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 0 owner 0 owner's a eat. , Owner/Agent Signature Telephone No. PERMIT FEE: �+,�.��w,..