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HomeMy WebLinkAboutBLDE-22-004756 Commonwealth of Official Use Only
itiiietio,
-, Massachusetts Permit No. BLDE-22-004756
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:2/28/2022
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 wor dggibed below
Location(Street&Number) 8 BURCH RD C 03��
Owner or Tenant THIERWECHTER GLEN P Telephone No.
Owner's Address 8 BURCH RD,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 ❑ 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: Renovations
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
on 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 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:) fFu 3,53 7551
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: ANDREW M LEVESQUE
Licensee: Andrew M Levesque Signature LIC.NO.: 17318
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:461 LOWER COUNTY RD, HARWICH PORT MA 026461831 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: $150.00
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�+ Occupancy and Fee Checked
--_—_ e BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07
•`rT��,�. ] (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: 2/21/2022
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) 8 Burch
Owner or Tenant Kyer Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes CI No ❑ (Check Appropriate Box)
Purpose of Building residential Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead El Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wiring of renovation
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
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
Totallo.of Ranges No.of Air Cond. T ns No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection
Heating Appliances KW Security Systems:*
No.of DryersNo.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or E uivalent
No.H dromassa a Bathtubs No.of Motors Total HP Teto fDeviceio or Equivalent
y g No.of Devices 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: 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 insuranceincluding"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 P) BOND ❑ OTHER ❑ (Specify:)
I certify,under the pants and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Harwich Port Heating &Cooling, LLC LIC.NO. 593 Al
Licensee: Andrew Levesque Signature i LIC.NO.: 17318A
(If applicable,enter"exempt"in the license number line) a % Bus.Tel.No.:508-432-3959
Address: 461 Lower County Rd, Harwich Port, MA OkoLio Alt.Tel.No.:
*Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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)0 owner ❑owner's agent.
Owner/Agent PERMIT FEE: 150
Signature Telephone No.
** Please fax a copy back to us at 508-430-6075 **
or e-mail to: keciaahphcllc.com
HARWICH PORT
HEATING&COOLING,LLC
Town of Yarmouth
Attn: Building Department
1146 Route 28
South Yarmouth, MA 02664
Dear Sir/Ma'am,
The electrical rough at 8 Burch Road, South Yarmouth was completed and
inspected by a licensed electrician on February 22, 2022. All work done by
Harwich Port Heating and Cooling, LLC was done in accordance with the
current NEC electrical code. Installation was done in a correct and safe
manner.
Thank you,
Andrew Levesque
General Manager
License Number 17318A
461 LOWER COUNTY ROAD, HARWICH PORT, MA 02646
TEL. 508-432-3959 OR 800-427-3959 ♦ FAX.508-432-6075
•
TOWN OF
i* [!
1146 P�t�[ ? E 2 UTh YA!'Mfir;UTH, 026
• F,gi,'} n 5O.: -0836
'HONE: 50:,-.11-2231 a`, 1 53
ICEN EUKYIT 9:00
REQUEST FOR ELECTRICAL INSPECTION:
•
DATE: 7 (9--DDATE REQUESTED FOR INSPECTION.; 17/21 . -
V �( j � +( V
ADDRESS; MPt f 4
OCCUPANT. 9/E
TRENCH: ROUGH:
SERVICE: FINAL: •
NSTAR WORK ORDER NUMBER:
OTHER:
PERMIT UNDER: HARWICH PORT HEATING.& COOLING •
. . PHONE: 508-432.3959 FAX: 508 432-6075 .
LICENSE : 17318 4 .
x Ct.)/-E O 0
SPECIAL INSTRUCTIONS.