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Home My WebLink AboutBLDE-22-004093 uiN k� Commonwealth of official Use Only '€ Massachusetts Permit No. BLDE-22-004093 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:1/25/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this aplication the undersigned gives notice of his or her intention to perform the electrical k ribcd below. Location(Street&Number) 9 Vernon St 4"xy /� Owner or Tenant MICHELLE GRAVELINE/GRAVELINE TRUST Telephone No. ��k'�C=J `-N Owner's Address 9 VERNON ST,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appop 'ate Boxl `� Purpose of Building Utility Authorization No. T�.ry £ (7 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: Rough&final 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 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 Ranges No.of Air Cond. Total No.of Alerting Devices Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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 ❑ 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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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: $150.00 f L—&-Oegtf— f‘e/751-, Le ittkoefr 5 ( �(A Ab let (o his , V2J/7 1,1 .. 'R'A NS.LP Ce i ) 9, & ' '� c.vmmvn weat II VI VI ►7va4 v••..w�go gm+ h �Z—t-Fa�3 „� Department of Fire Services Permit No. Occupancy and Fee Checked - __ 1-{ -', BOARD OF FIRE PREVENTION REGULATIONS Rev.9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 /A I 0 City or Town of: YctoY‘otk7,th 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) 0 Ve trnc-)vi fit Owner or Tenant Cry tw ite -F\yl d VYCk_—1 j�/�-- Telephone N . 4 Owner's Address -i.)O f ) F KA ✓1 n' ►YiFk C1 f Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Services)Amps i:2(.)/()go Volts Overhead ❑ Undgrd KI No.of Meters I New Service Amps — / Volts Overhead❑ Undgrd L No.of Meters Number of Feeders and Ampacity Vert Location and Nature of Proposed Electrical Work: rD(}rjh ....f_ rl\ to Ace_ -l.�t / Completion of the following table may be waived by the Inspector of Wit es. No.of Recessed Luminaires No,of Ceil.-Susp.(Paddle)FansTaofTotal sormers KVA No.of Luminaire Outlets No.of Hot Tubs r Generators KVA Above In. No.or Emergency LighiFing No.of Luminaires Swimming Pool grnd. grnd. ❑ Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners I 'O.o i etect on and No.of Switches Initiatzn Devices No.of Ranges No.of Air Cond. Toms No.of Alerting Devices Heat Pump Number Tons ICW No.of Self-Contained No.of Waste Disposers Totals; Detection/Alerting Devices cip No.of Dishwashers Space/Area Heating KW 1 L o c al❑ M Connuniectional 0 Other Heating Appliances KW ecurlty Systems:* No.of Dryers No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring; Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsN .ofDeDevices or airi a No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value Ei tricai Work: When required by municipal policy.) Work to Start: I ( i,/-U 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 iMi 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:PN N L.5..CT CMC..,I LIC.NO.:MOL -IS Licensee: 1-4LEV. W• Pft'I NE Signature /:,!? / LIC.NO.: 2.O;. — (If applicable enter"exempt in the license number line. S,,I U Bus.Tel.No. r e I Address: P.(). 'iOX I D1S SOJ �' CIA t 0LLo lD 1 Alt.Tel.No.: ji1014711 *Security System Contractor License required for this work;if applicable,enter the license number here: 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) ❑owner 0 owner's agent. Owner/Agent Telephone No. PERMIT FEE:$ Signature -AV-6 7)2.- 73t1E2r— 6-kIrdetr n1vT / rALISO W r/Le &AV -sill-ties Abrd