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Home My WebLink AboutBLDE-22-005984 Commonwealth of Official Use Only " I.' Permit No. BLDE-22-005984 t. Massachusetts 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:4/19/2022 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) 83 QUARTERMASTER ROW Owner or Tenant Jeff Wilson Telephone No. Owner's Address 83 QUARTERMASTER ROW, 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. 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: Bring basement up to code.Work done without permits. 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 Initiating Devices To No.of Ranges No.of Air Cond. Ton 1 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 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 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: Michael D Hollister Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD, S YARMOUTH MA 026641017 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:$250.00 RECEIVED 4, .14 APR 19 20? o O..a a maadachuaatfe Official Use Only °'>if i lLDING UEPHRT N7 9. n 7/t �� spartrurnt o�� w Jsrvtcsd Permit No. �/��S� jL V "- }''`I' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked J "' [Rev. 1/07] (leave blank) i. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC,527 CMR 1 .00 k (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �/ Z L City or Town of: YARMOUTH To the Inspe for of Wi es: By this application the undersigned giv s notice of his or her intention to perform the electrical rk described below. Location(Street&Number) 3at)A-1";Sttei As� n icOsecr .) Owner or Tenant r�4 /L C`.,'r Telephone D v p ne No. 737 ��z Owner's Address v Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building gt ' /✓CC•�' (Check Appropriate Box) l Utility Authorization No. Existing Service�.i 7.,(/..) Amps / Volts Overhead 0 Undgrd g ❑ No.of Meters r New Service Amps / Volts Overhead ❑ Undgrd El No.of Meters v Number of Feeders and Ampacity % 1 Location and Nature of Proposed Electrical Work: a 4 !t iS/-IL`() i vl�E0 , O p e I^'t ►T L. ��C/�l kri Completion of the following aywaived table m be by Inspector of Wires. 1 ) \A C_.. nod No.of Recessed Luminaires No.of Cell:Sns . No.of Total p (Paddle)Fans N 'it No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA NI siNo.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting � �, grnd. grnd. ❑ Battery Units - No.of Receptacle Outlets No.of OIl Burners FIRE ALARMS INo.of Zones ~- No.of Switches No.of Gas Burners -No.of Detection and 11` No.of Ranges Initiating Devices No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number'Tons .1 KW No.of Self-Contained Totals: Detection/AlertinitDevices No.of Dishwashers Space/Area Heating KW Local 0 Municipal No.of DryersConnection 0 ��' tY Heating Appliances K�,l, 'Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters No.of KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of 1 tric 1 Work: f U Attach additional detail if desired,or as required by the Inspector of Wires. municipal policy.) Work to Start: 6 /4' 2 - Inspections to be requested(Wh in accordanceen required ywith MEC Rule 10,and upon ion. INSURANCE C ERAGE: Unless waived by the owner,no permit for the performance of electrical work may tissue 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 IL BOND 0 OTHER 0 (Specify:) I certify,under the pains and nalties o fperjury,that he Information on th's application is true and complete. FIRM NAME: p ( � � � 4,Ll57 L[C.NO. G Licensee: Signature (If applicable,enter"exempt"in the/ic nse number line.) LIC.NO.: Address: �j'$ ill• p frwi,/i�J Bus.Tel.No. J5 *Per M.G.L.c. I�17,s.57-61,security work requires'D ent of Public Safety"S"License: Alt.Leel.No.: .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:$