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Home My WebLink AboutBLDE-22-000338 op � �o Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-000338 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:7/20/2021 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 d s ribed below. Location(Street&Number) 9 Vernon St kw+ tsbiz, cook Owner or Tenant MICHELLE GRAVELINE/GRAVELINE TRUST Telephone No. Owner's Address 9 VERNON ST,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Co Z,", 6 " Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence with Ufer grounding. 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. Ton l No.of Alerting Devices 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 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: Licensee: Shawn Micheal Ricard Signature LIC.NO.: 22895 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7748012921 Address:27 Baywood Drive,Orleans MA 02653 Alt.Tel.No.: 9788157031 *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:$230.00 (2 i * CeIJ U1r Ocn6 tie 14 l.ommonwsaa o`//Iamaachueslfa Official Use Only .>g � t t nsnt o�,} .S' Permit No. S22--O j�j tc3 ;et ;; v spar irs srvicsa ''`('' 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( EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date: -7 ig�� ir By this application the undersigned gives notice h intention to perform theTo the I�spector elect electrical workof des ribed below. Location(Street&Number) 9. tJi, 0,7 NJ Owner or Tenant U rQ`v''n°' Telephone No. Owner's Address Is this permit in conjunction with a building permit? yes �Q�.�� No ID (Check Appropriate Box) Purpose of Building R,f s t Utility Authorization No. to_ 1O of g`z 1 Existing Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters New Service t CC7 Amps /ae /,`LO Volts Overhead Number of Feeders and Ampacity ❑ Undgrd No.of Meters / E CLocation and Nature of Proposed Electrical Work: ‘.J ti r t �tk'✓ L SCc J is e_ V) NA, letion o the ollowin table m be waived b the In ector o Wires. t1.t No,of Recessed Luminaires No.of Cell:Sus . r.'' p (Paddle)Fans o.o ota '�'t No.of Luminaire Outlets Transformers KVA r_\ No.of Hot Tubs Generators KVA :` No.of Luminaires Swimming Pool ove n- o•o mergency g n rnd nd. ❑ Batte Units g `` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No,of Gas Burners o.o etec on an t` No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers eat ump um er ons Totals o.o e - onta ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local 0 un c pa No.of Dryers Heating Appliances Kor ecu ty Cstemstion om� o.o a er No.of Devices or E uivalent Heaters ' °'° o.o Data Wirin Si ns Ballasts g: No.Hydromassage Bathtubs No.of Devices or E uivalent No.of Motors Total HP a ecommun ca ons r g OTHER: No.of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: I (When required by municipal policy.) t� a 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 0 BOND THER 0 (Specify:) I certify,under the pains and penalties o errju Othat the information on this application is true and FIRM NAME: fp j -e ''`-�a'1 � � �(•C c�'C i� i complete. Licensee: " LIC.NO.:Sag-_ L^^� Ili to y IP Signature (If applicable,a ter a empt in the license rum er line.) LIC.NO.: /S Address: Aa Qiar H^� Bus.TeL No... T'Q9l *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance co required by law. By "S"License: Lic.No. Owner/Agent my signature below,I hereby waive this requirement. I am the(check onecoverage normally Signature � owner / owner's a:ent. Telephone No. PERMIT FEE:$