The URL can be used to link to this page

Home My WebLink AboutBLDE-22-000407 Commonwealth of Official Use Only riveik E a;�� Massachusetts Permit No. BLDE-22-000407 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:7/22/2021 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 described below. Location(Street&Number) 475 NORTH DENNIS RD Owner or Tenant PETERSON DAVID P Telephone No. Owner's Address PETERSON SHIRLEY A, 157 SOUTH DR, BRIDGEWATER, MA 02324-2361 , J ifiliti•' Is this permit in conjunction with a building permit? Yes 0 No 0 v- Purpose of Building Utility Authorization No. ,-,- ;1= ° Existing Service Amps Volts Overhead 0 Undgrd 0 '� _ ,. , New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC&panel change. 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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 0 Other: Connection 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 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: Matthew Kane Signature LIC.NO.: 55328 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 Harvard Street, South Yarmouth Ma 02664 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 01 g 7 23 I2t Consava,we r h oit Middricksadis Official Use Only . 411 apartment olglnr Services Permit No. Occup._ ►i BOARD OF FIRE PREVENTION REGULATIONS nn`y and Fee eked Rev. l/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 01 oZ I City or Town of: Jtirrnoc, 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) if-7 5 Na r w, Penn ;S (3 d 5 94 cr." Owner or Tenant Del v;d Pe4ers6 r Telephone No. Owner's Address `OS No di, Demon‘1s Rd S - 90i,r t" Is this permit In conjunction with a building permit? Yes 0 No Er (Check Appropriate Box) Purpose of Building Utility Authorisation No. Existing Service /00 Amps /da 143d Volts Overhead 0 Undgrd❑ No.of Meters _ New Servicg Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity - /Cy,At Location and Nature of Proposed Electrical Work: Rakm,nt P,4/V Et OA>b y Ghee R effo,ind f fvoace' h c rew,r� Completion oj the lollowingtableme*be waived by the Inn for of Wires. No.of Recessed Centrals No.of Cell.-Snap.(Paddle)Fans No.or Transformers Total No.of Luminalre Outlets No.of Hot Tubs Generator KVA No.of Luminatrei Swimming Pod Above r-i In- rims or Emergency Gtgpung o and. tmtd. ❑ Battery Units L No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 'No.of Zones No.of Switches No.of Gas Burners I Na of Detection and No.of Ranges No.of Air Coed Tons , I Total No.of Ddadna evices Devices No.of Wash Disposers Heat Pump Number Tons KW Ne:oISelFcoatalasd Totals:I I I Del doelAlertfngc Dertces No.of Dbbwasbers Space/Area Heating KW Local❑ Munnleipal i Coaeeetloa 0 Other _ No.of Dryer Heating Appliances KW Security S�st.sass. No.of Water No.ofNo.of Merkel or Equivalent Heater KW Signs No.lisib Data Wirings r No.of Devices or Equivalent No.Hydromasagst Bathtubs No.of Motors Total HP 'I elecommunkatlons Wlria OTHER: No.of Devices or Equlvant Qi Estimated Value of Electrical Work: Attach additional detail Y'desire or as required by the Inspector of Wins. Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. \s 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 t� CHECK ONE: INSURANCE 0 BOND proof of same to the permit issuing office.❑ OTHER ❑ (Specify:) (1 I certiAt,under the pains and penalties of pedusy,that the Information on this application Is true and complete. -..< FIRM NAME: /'Y tf kin (/e> ._.1 Licensee: _t'yl f-lh ew /tea n p Signature LIC.NO.: 53 � 8Of applicable,enter exempt rn the lksmt nunebp )lint �s%��Z- LIC NO.:�53o�Ff (3 .4 Address: �S 1-Farvc ram( s�- yarm t�m4 6 F,� Bus.Tel.No.; 7)`f- G4y- 7570 'Per M.O.L.C. 147,s.ST 61,security work requires Decety Alt Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that phs a Liic tensee dou,rot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I ant the(check one I owner ■ owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:1