The URL can be used to link to this page

Home My WebLink AboutBLDE-22-005098 a. r;%/ Commonwealth of Official Use Only €. tu vr CV Massachusetts Permit No. BLDE-22-005098 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:3/15/2022 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. Q Location(Street&Number) 7 MEADOWBROOK RD `111 (f6 -- 1 87 Owner or Tenant DESMARAIS JEFFREY M Telephone No. Owner's Address PAPADOPOULOS HELENA A, 7 MEADOWBROOK RD,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. 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: ,- 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 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 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: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 (N11(2_ ,(?,I (12/ M Nye Q1g c(17.4722. -2. . ect,d� cr 4al Z2 ( - f,�IG- 89') AA�� (ao e to I',) 114 Conrmotewtaith `:'" "^ 0/Mamacitusetfe Official Use Only ar,„ 5 -Uspartmutf o`,}iro s rvicse Permit No. -- 1i"a BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _ .> [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 RK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: y' r z L City or Town of: `r By this application the undersigned notice to perform the To the electrical work ire: Location(Street&Number) described below. 1 ot.v / Owner or Tenant r� `r Telephone No. y Owner's Address _ 22 ` ,1_ ; yv�/7 Is this permit In conjunction with a building permit? Yes 2 No Purpose of Building ,,� ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Z Gp Amps 70`_Volts Overhead ® Undgrd 0 No.of Meters _L New Amps / Volts Overhead❑ Undgrd Number of Feeders and Ampadty g ❑ No.of Meters I Location and Nature of Proposed Electrical Work: 4 s rfg Completion o the ollowin• table m, be waived b the In , j No.of Recessed Luminaires ctor o Wires. No.of Cell.-Snap.(Paddle)Fans °•o ota �; No.of Lumiasdre Outlets Transformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool . Oave ❑ Batte U n- 'o.oe m nits • ergency g, 'ng ' No.of Receptacle Outlets °d•d No.of Oil Burners No.of Zones "` No.of Switches No.of Gas Burners `o.o I etec on an• t No.of Ranges Initiatin, Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat 'nmp `um er. ons Totals: ...__._.__._..._ o.o e out a , No.of Dishwashers Detection/Alert . Devices Space/Area Heating KW 'un c No.of Dryers Heating Appliances Lo c cual Connection ❑ Other KW ly ystems: o.o Aeaters KW `o.o .o•o No.of Devices or E•uivalent Si:ns Ballasts Data Wiring: No.of Devices or •uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun a ions " r •g: OTHER: No.of Devices or E,uivalent Attach additional detail ifdeslred,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVRAGE: Unless waived by the owner,no permit for the performance of electrical work may issue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuingo unless CHECK ONE: INSURANCEThe I certify,under the pains and 0 BOND 0 OTHER 0 (Specify:) ice. FIRM NAME: penalties of perjury,that the lnforntalion on this application is true and complete. Licensee: LIC.NO.:--------____ (If applicable.enter"exempt"in the license number line.) Signature Address: LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requires De OWNER'S INSURANCE I Bus.Tel.No.• -r parlment of Public Safety"S"License: Alt.Tel.No.: VER: I am aware that the Licensee does not have the liability insurance overage normally required by law re below,I hereby waive this requirement, I am the(check one • owner Owner/Age Signature � owner's a:ent. Own Telephone No.. -22� ��2 PERMIT FEE:$ ___ tso