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Home My WebLink AboutBLDE-23-001033 Commonwealth of Official Use Only �,I Massachusetts Permit No. BLDE-23-001033 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:8/26/2022 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) 17 SHELTERED HOLLOW LN Owner or Tenant HAYES EDMUND M Telephone No. Owner's Address HAYES DOROTHY E, 17 SHELTERED HOLLOW LANE,YARMOUTH PORT, MA 02675-1544 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: Install generator 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 1 KVA 14 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 No.of Detection and Initiatine Devices No.of RangesNo.of Air Cond. Total No.of Alerting Devices Ton 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 ❑ 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 Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Licensee: JULIAN ROBINSON Signature LIC.NO.: 58376 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126 Santuit Road, Marstons Mills MA 02648 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 gfi. A (row , RECEIVED • AUG 2 5 .2O2ro , •a&o`maeaac/u Official Use Only P. ,t •�■� /c�, � Permit No. c...,;- DING D k PA R T M ' „ of girls erviced Occupancy and Fee Checked : e - . . •REVELATION REGULATIONS [Rev.l/07] heave 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 TYPE ALL INFORMATION) Date: cd 2 5 72°2Z City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gwis notice ofhis or her intention to perform the electrical work described below. Location(Street&Number) 1,, 51 e(+e t.-eit 4.,j l o , (te a h.e Owner or Tenant E,j-vti toiA o(. H c,yCS Telephone No. c6Sr-UU 2_7o to Owner's Address Is this permit in conjunction with a building permit? Yes 0 No Pa (Check Appropriate Box) Purpose of Building G-el, ev-,.••kt' Utility Authorization No. Existing Service 10 0 Amps (lo/ 1410 Volts Overhead❑ Undgrd p No.of Meters I New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: R i Lt.I- of- ,94ie v,,,,t.. G-t-W 4 v kf..v- 0y Completion of the folloivinktable irw be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Snip.(Paddle)Fans No. aaaformers KVA ral 1 No.of Luminaire Outlets No.of Hot Tubs Generators ( KVA j t-( n Above in- k No.of Emergency Lighting No.of Luminaires Swimming Pool�� ❑ grad. ❑ Battery Unit g ',} No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiatlns Devices IV No.of RangesNo.o Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons .KVV No.of Self-Contained Totals: — Detection/Alertin Devices No.of Dishwashers Space/Area Heating KWal Municip Local❑ Connection 0 Omer No.of Dryers Heating Appliances KW No.Security Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Tel N mm is or EquWir .ent OTHER: • Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: C 0 b (When required by municipal policy.) Work to Start: T./Z 4'tit 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 50 BOND 0 OTHER 0 (Specify:) I cerd,f y,under the pains and penalties of pedury,that the Information on this application is true and complete. FIRM NAME: 5 y l l/i a. &'-oaf LIC.NO.:. Sfs'3 2 6-6 Licensee: 3-U 1 i'^h R .o 61 h r o t Signature ¶LAAni/ LIC.NO.: S 3 ( d (ifapplicable, "exem t in the license number line. Bus.TeL No.: `(" `Y- r2 Address: 11-io S Ls+U i. IVe1,1'�Qw. {2pif'14v(4'`"t u+� l(S Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: 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)0 owner 0 owner's agent. Owner/Agent Telephone No. I PERMIT FEE:$