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HomeMy WebLinkAboutBLDE-23-001238 t L�1 Pill Official Use Only
or Commonwealth of
�...�'►� ' Massachusetts
Permit No. BLDE-23-001238
KY 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:9/7/2022
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) 91 CHIPPING GREEN CIR
Owner or Tenant SUE QUIMBY Telephone No.
Owner's Address 91 CHIPPING GREEN CIR, 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. 10339398
Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service 200 Amps Volts Overhead ❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Upgrade service.
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 grade ❑ grnd. ❑ Batter Emergency Lighting
y Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Detection and
No.of Switches No.of Gas Burners Initiatine Devices
No.of Air Cond. Total No.of Alerting Devices
No.of Ranges Tons
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers Totals: Detection/Alertine Devices
Municipal 0 Other:
No.of Dishwashers Space/Area Heating KW Local ❑ Connection
Security Systems:*
No.of Dryers Heating Appliances KW No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Siens 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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.: 22967
Licensee: Jon T Moreau Signature
Bus.Tel.No.:
(If applicable,enter"exempt"in the license number line.) Alt.Tel.No.:
o.
Address:9 Redberry lane, MARSTONS MILLS Ma 02648
*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 I
Signature Telephone No. I PERMIT FEE: $50.00
14 n ��jj Official����."" se Only
Consnwnwra o�N/aeeac�eaa.ifd Permit No. E2. .. �3 6
: �*�rtmeni el gins *� Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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
l (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/6/2022
ma 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) 91 Chipping Green Circle
Owner or Tenant Sue Quimby Telephone No.
ow
Owner's Address A l Chipping f rPP n C',,ircle
Is this permit in conjunction with a building permit? Yes ❑ No hJ (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No. 10339398
. ._ Existing Service 100 Amps 120/240 Volts Overhead[Y Undgrd❑ No.of Meters 1
s' New Service 200 Amps 120/240 Volts Overhead[7 Undgrd 1: No.of Meters 1
Number of Feeders and Ampacity 3/700
Location and Nature of Proposed Electrical Work: Service Upgrade
L Completion of the follawing.table mug be waived by the Inrlc r of Wires.
No.of Total
t No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans Transformers KVA
No.of Luminaire OutletsNo.of Hot Tubs
Generators ICVA
Above In- No. Lighting
No.of Luminaires swimming Pool grnd. ❑ grnd. ❑ Batteofry Units
' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
"� No.of Gas Burners No.of Detection and
�C No.of Switches Initiating Devices
i 1 i No.of Ranges No.of Air Cond. Total
od No.of Alerting Devices
Heat Pump Number _.jKW __.,. No.of Self-Contained
No.of Waste Disposers Totals:I I I Detection/Alertin Devices
Municipal ""--
No.of Dishwashers Space/Area Healing KW Local❑ Connection ❑
HeatingAppliances KW Security Systems:*
No.of Dryers pp No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts 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: 7740.00 (When required by municipal policy.)
Work to Start: 09/07/2022 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
fimanc or electrical
its csubcal work
ol may
issue
Theess
the licensee provides proof of liability insurance including"completed operatiocn"
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE V BOND 0 OTHER 0 (Specify:) tn
I co.*,under the pains and penalties of perjury,that the information on this application trueandLI c complpkte.
: 22967-A
FIRM NAME: Coastal Mechanical ?,�,2�� LIC.NO.: 8082 Al
Licensee: Jon T Moreau Signature rL
Bus.TeL No.: F08-737-8747
(If applicable,enter"exempt"in the license number line.) Alt.TeL No.:c08� '17-87 9
Address: 21 L Fruean Ave S. Yarmouth MA 0266t ofPubtic Safety"S"License: Lic.No.
*Per M.G.L.c. 147,s.57-61,security work requires
OWNER'S INSURANCE WAIVER: I am aware thatt the this Licensee
does
I not
have (the liability k one)i❑ownensurance
o er oner'sge normally agent.
required by law. By my signature below,I hereby requirement.
Owner/Agent Telephone No. 1 PERMIT FEE:$ 50.00
Signature