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Home My WebLink AboutBLDE-22-006605 ,r- _. 1 Commonwealth of Official Use Only k Massachusetts Permit No. BLDE-22-006605 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:5/17/2022 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) 12 SALTWORKS LN Owner or Tenant GREW THOMAS A Teleph i i • : .. Owner's Address GREW VIRGINIA A, 2 ATLANTIC AVE, SOUTH YARMOUTH, MA 02664-1• i Is this permit in conjunction with a building permit? Yes 0 No / (Check Appropriate Box) Purpose of Building Utility Aut I rization No. Existing Service Amps Volts Overhead 0 ndgrd 0 No.of Meter New Service 100 Amps Volts Overhead 0 ndgrd 0 No.of ers Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Temporary service. 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 No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons 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 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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: 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: $50.00 &le: Commonwealth of Massachusetts Official Use Only * Permit No. �i�i2' � � i� � Department of Fire Services �- Occupancy and Fee Checked `\��. BOARD OF FIRE PREVENTION REGULATIONS IRev.9/0SI (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 1.VFORMATIOA) Date: IA at4 lb, , v -.)-- City or Town of: f cc i rYNOLA- '1 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) I a S 1-�1A.,ram l Gt I'b(.., Owner or Tenant (oi(Y to v"eCI.) Telephone No.-no, ,;L),2-3 g v_. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate-Box) Purpose of Building _Dlia ( O LOCI Utit''--Authorization No. Existing Service II��O Amps I / Volts Overhead J Undgrd❑ No.of Meters D New Service I Amps /20/ 2 OVolts Overhead L1j" Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: L, p ce i;'�,lI( �.— Completion of the following table may be waived by the Inspector of Wiles. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA KVA No.of Luminaire Outlets No.of Hot Tubs Generatorse.ot ltt enc Lighting SwimmingPool Above ❑ In- ❑ g y g g No.of Luminaires grnd. grnd. Battery 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 Initiatin Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons - Heat Pump I I Number (Tons 1KW No.of Self-Contained No.of Waste Disposers Totals; Detection/Alerting Devices No.of Dishwashers Space/Area Heatirg KW Local❑Municipal Connection Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water No.of l Data Wiring; Heaters KW Si. i I l C -I t I►n No.of Devices or Equivalent Telecommunications Wiring No.Hydromassage Bathtubs No.of livalc_c✓ '4 No.of Devices or Equivalent OTHER: tired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: )al policy.) Work to Start: 51 i H�9 d- Inspections to sC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived b; nance 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, afi BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the irformatioa on this application is true and complete. FIRM NAME: E LE.CT . LIC.NO._5 OL1"S Licensee: 'ME Val• sty NE Signature 4- ,�,. (If applicable,enter "exempt" in the license number line. Bus.Tel.No.: �y� Address: p.p. BOX tolcA SaMi phi f-Yi tUtiapplicable,% 07i&lA\license numberAlt. Tel No.: ram-f *Security System Contractor License required for ere: OWNER'S INSURANCE WAIVER: l am aware I herebywaaettthis requirement.he Licensee does not I am the(check one)i❑iowner coverage❑owner rs agent. required by law. By my signature below, Owner/Agent Telephone No._ I PERMIT FEE:$ Signature