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HomeMy WebLinkAboutBLDE-22-005122 - Commonwealth of Official Use Only �, Permit No. BLDE-22-005122 i h� Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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. Location(Street&Number) 43 MONTAGUE DR Owner or Tenant Marilyn Holman Telephone No. Owner's Address 43 MONTAGUE DR,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: Install generator. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators 1 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 Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices i Space/Area Heatn Local ❑ Munici al No.of Dishwashers P g KW Connection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Sins No.of Devices or Eauivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Eauivalent • OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Value of Electrical Work: (Whenq P P y') 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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: $75.00 --rat:1•1..fl•0 e6/VOU-Ir V2-4172.-- t•-Y,e_ 3 Z(2v/ (riAOAS kidr V L r 89 My 11 J RECEIVED D v A' �/ MAR 15 202 ° • .aith 7 i//aQeac�ue.(fe mild Use Onl ` evvicee - I. '" ii__ GILDING utH/ RT 'a' „ ive PcnnitNo. ,� �� ' • ' - • • ' ` "EVENTION REGULATIONSOccupancy and Fee Checked (leave blank) rd APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I 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-)s-as'3- City or Town of: YARMOUTH To the Inspector of Wires: + py this application the undersigned gives notice of his or her intention to perform the electrical work described below. `.) ‘1) Loci alien(Street&Number) 143 fA oR}t:�.,q Je. N— IL Owner or Tenant PAAe-i 1 R %(,M o.(1. l c), Owner's Address u 3 JV1 A-a t - DTelephone No. �as;2 4�3j7 Is this permit in conjunction with a building permit? Yes 0 purpose of Building ❑ No 0] (Check Appropriate Box) ��� r c Utility Authorization No.n !listing Service Amps ps / Volts Overhead 0 Undgrd❑ No.of Meters _ New Service Amps / Volts Overhead ,� ❑ Undgrd‘❑ No.of Meters v Number of Feeders and Ampaclty F7 Location and Nature of Proposed Electrical Work: 5-k.c A\ n e,G. �3`k. \\OJ S� TnskK1� vt1,e.,3 coo t\a �`c eS 3 eve rCti��c- rlii rF Completion of the following_table mmt be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Snsjr.(Paddle)Fans No.of Total Na of Luminsh'e OutletsTransformers KVA (CANo.of Hot Tubs Generators KVA -` )lo.of Luminaires Swimming Pool rive [] In- No.a Units Lighting ti' �Io.of Receptacle Outletsnd ❑ Battery �A. , No.of Oil Burners FIRE ALARMS lNo.of Zones No.of Switches No.of Gas Burners 'No.of Detection and 111 No.of Its Initiating Devices ° No.of Air Cond. Tonal tNo.of Alerting Devices 4o.of Waste Disposers Heat Pump Tons W No.of Self-Contained No.of Dishwashers Totals:1!plumber-} __goy__--µ Detection/Alerting Devices Space/Area Heating KW ❑ COQni�n 0 Other No.of Dryers Heating Appliances KW OFyate�: o.o Her o.o o,o No.of Devices or uivalent S eaters n." a Ballasts Data Wiring: No.of Devices or Divalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun a nor gg OTHER: No.of Devices or Eauivalent Estimated Value of Electrical Work: 3 0 t7Q Attach additional detail if desired,or as required by the Inspector of Wires, Work to Start: 3—j 5-a,'� (When required by municipal policy.) 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 (;S BOND 0 OTHER ❑ (Specify:) I certify,under the ins and na- of pedury,that the information on this application is true and complete. FIRM NAME: S\vc. Q-e Jy\2. Iz.Ve ekv «(0\ ©5 h 1/4)c, t LIC.NO.: Licensee: DG Jo Signature C9(„_ LIC.NO.: S3 T i— (If applicable,enter"exempt in the license number line.) / Address: Bus.Tel.No.: '7'7 $3 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public SafetyS"License: Alt.TeL No.: OWNER'S INSURANCE WAIVER: i am aware that the Licensee does not have the liability insurance coverage normally rOwner/Agent equired by law. By my signature below,i hereby waive this requirement. I am the(check one MI owner ■ owner's a:ent. Signature Telephone No. PERMIT FEE:$