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Home My WebLink AboutBLDE-23-000047 1\cg Commonwealth of Official Use Only I. g Massachusetts Permit No. BLDE-23-000047 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07J 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) pate'7/5/2022 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) 35 ANTLERS RD Owner or Tenant Adam Lapoh Telephone No. Owner's Address 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: Above ground pool. 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 K bovend. ❑ g rnd. ❑ No.of Emergency Lighting r Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained 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 Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: 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: JULIAN rOBINSON Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 58376 Address: 126 Santuit Road, Marstons Mills MA 02648 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 D owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$65.00 '!-a 7/e/ . -'- '.s E 1 !� E V JUL 0l2022 Commonweanh 7 �a��+ �a Official Use Only BUIIDIN�r -r„„7rMENT c/ ey: _� �':: � 2spartmsnf° ipe S'srvicsd Permit No. �Z3 .> il +` a�41„ y BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07] (cave blank i APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code( WORK c-�1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) �J City or Town of: Date: ��a ZZ \v YARMOUTH To the Inspector of Wires: .s' By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) N g� 0 Owner or Tenant of..+,,iA 01, Telephone No. - '-j! Owner's Address S C—�� ems !Z ! o Is this permit in conjunction with a building permit? Purpose of Building_66 o V{ �y�,a y ,0 0 �� ❑ No (Check Appropriate Box) s I -_Utility Authorization No. Existing Service JAI Amps 6/ 2,`(d Volts Overhead It Undgrd❑ No.of Meters l New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd❑ No.of Meters i Location and Nature of Proposed Electrical Work: l `�c 4 �()VCC 1>,aU�,k. Pral 0 4 val %.,‘r Completion o the ollowin_ table m 0f No.of Recessed Luminaires be waived b the In .ector o ]fires. No,of Cell.-Sasp.(Paddle)Fans •o•o ota .e•Zt No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA KZ t' No.of Luminaires ns ove n- 'o.o Units cy g n SwimmingPool ,rod. d 0 g �` No.of Receptacle Outlets n Batte Units I No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'o.o etec on an I�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 - oats ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local 0 un c p No.of Dryers Heating Appliances ecu Coonnection ❑ � `o.o "a er KW No. f Devicmes or E.uivalent Heaters KW °•° `o,o Si ns Ballasts Data Wiring: No.Aydromassage Bathtubs No.of Devices or E.uivalent No.of Motors Total HP a ecommun ca s ons " ,g: OTHER: No.of Devices or El uivalent ��j Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: a U—d- (When required by municipal policy.) 1 2 lI Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 R BOND 0 OTHER I certljy,under the sins and penalties o 0 (Specify:) FIRM NAME: (/ (i jPerJury,that t e information on this application is true and complete. ' o f;il-, 0 C C.{k C Licensee: 3V l i�� o(,4 o t LIC.NO.: �3?(,' II (If applicable,a lox exempt' in the/rcens number �I,Signature 4 Address: b q 1/1-4- e WI)1 /,�, LIC.NO.: *Per M.G.L.c. 147,s.Ok, security work requires De if° S (k 1 (S Bus.Tel.No.• Pub OWNER'S INSURANCE WAIVER: I am aware thathhc Department Licensee does c not havehe liability insurance coverage required by lave. Byafety"S"License: Lic.No. Owner/Agent la signature below,I hereby waive this requirement. I am the(check one g normally kte Signature ■ owner • owner's a:ent. elephone No. (f'-dtrz PERMIT FEE:$ - : ' 4 6s-cam