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Home My WebLink AboutBLDE-21-005055 of< \k/0 Commonwealth of Official Use Only 4_ Massachusetts Permit No. BLDE-21-005055 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'3/9/2021 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) 20 ELLIS CIR Owner or Tenant MOSER MARCIA J (LIFE EST) Telephone No. Owner's Address 20 ELLIS CIR, YARMOUTH PORT, MA 02675 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 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 and transfer switch. 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 13 No.of Luminaires Swimming Pool g bovend ❑ IInnd ❑ No.of Emergency Lighting r . 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 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent NHo.of s Water KW No.of No.of Data Wiring: Signs Ballasts 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: A J PULLEY Licensee: A J Pulley Signature LIC.NO.: 21843 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:289 QUAKER MEETING HOUSE,RD,E SANDWICH MA 025371366 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 signature below,I hereby waive this requirement.I am the(check one) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. 'PERMIT FEE: $75.00 I V?At '-I A coNothr Lf4 /za t , Comnumtvealh o/lilaJoachuiett9 Official Use Only .1 Permit No. /eW Thepariment o .. ire-Serviced J. Occupancy and Fee Checked '' BOARD OF FIRE PREVENTION REGULATIONS [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 TYPE ALL INFORMATION) Date: 3/,l Z i City or Town of: t A,2,,,,,.,-,.,rii To the Inspector of Wires: By this application the undersigned g' es notice of his or her intention to perform the electrical work described below. Location(Street&Number) ,;_;5 (,,1 r , i /,Pc,„2. Owner or Tenant 1.1,1c S ciZ LL-i A,:)„e-,,, Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑' (Check Appropriate Box) Purpose of Building 1 ,Dt a7,,,. c Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In,57'd}Lt_,, ,i,, /3 iGt v(4..)va"I2.4-77 A4yvA it'-r,,Zeu,T MA,`u i'�&92_ i0,4")-&--4._ 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 13 iL C No.of Luminaires Swimming Pool Above In- No.of Emergen ighting ❑ ❑ -Igrnd. grnd. Battery Units $. No.of Receptacle Outlets No.of Oil Burners 'FIRE ALARMS No.of Zones S No.of Switches No.of Gas Burners No.of Detection and il Initiating Devices C No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers ,$) Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent J Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent s:, No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent i 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: 3/q/ i 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 Er BOND ❑ OTHER ❑ (Specify:) I certify,under the pains andpenalties o p ) f perjury,that the information on th' pplication is true and complete. FIRM NAME: 1-1A4.4._6),,`, Cam, -S -.1 &tr-'Cr#2.Je_ LIC.NO.: Licensee: ,,A.7 ft L c. Signature 1 (If applicable,ever"exempt"in the license number line) ✓ LIC. oN , i ,Y' Address: l ' r3� ',lei ; Si`�,ri i1rT,. Ci is iRis Bus.Tel No.: SAY3�i>'3,r3 i *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.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 ❑owner ❑owner's a_•ent. Owner/Agent Signature Telephone No. PERMIT FEE:$