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Home My WebLink AboutBLDE-22-005361 Commonwealth of4. 4 Official Use Only nMassachusetts Permit No. BLDE-22-005361 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:3/24/2022 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) 7 MONTEREY LN Owner or Tenant DEBLOIS DANIEL F Telephone No. Owner's Address DEBLOIS MAUREEN J,20 GREEN PASTURE RD, BETHEL, CT 06801 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service, E.V.receptacle, &generator switch 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 KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiatine Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices Municipal No.of Dishwashers Space/Area Heating KW Local 0 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 Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 ❑ 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: Michael D Hollister Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD,S YARMOUTH MA 026641017 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 I ' RECEIVED • 2 4 2022 e 1 � aa`` y�j� / �/ M ,, Commonwealth o f///aedachadelle Official Use Only r e.PARTMENT � r V B I J c �'] �7 Permit Not1� aj CG By rt tl1 ,z-jfti --------- �Us/vartmsnf o�Jiro Jsrvresd 9£, Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) q APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK T All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 MR 12.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2j 2�� e 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. J Location(Street&Number) 7 fVf a/7 g j�` Z{ i- V CaOwner or Tenant j1,L-et(j E.' C._ / /1/4e -AI De-5c 4f S Telephone No.a 'j 99'9 O 703 V Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Purpose of Building21 Appropriate Box) r rNC Utility Authorization No. gS J 7 3 oa �. Existing Service /d U Amps / Volts Overhead Undgrd❑ No.of Meters I uP New Service _2476 Amps / Volts Overhead 7 Undgrd 0 No.of Meters /I— Number of Feeders and Ampacity ��E- d e6,g.��, 7-G ,a-,c) An."' r roposed Electrical Work:Location and Nature of Pisv'asU ��U� C'7O�- di j �1 �r�' 97C/ W/TG vl 4 �U Completion of thefollowin&table may be waived by the Ins sector of Wires. n!�, No.of Recessed Luminaires No.of Ceil:Sus . No.of p (Paddle)Fans al Transformers KVAt No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,t,. 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 JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Tota 1 i Initiating Devices No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump ,..._umber. Tons .. KW No.of Sell Contained Totals: �'' '"'" "'{"" Detection/Alertin. Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ timer No.of Dryers Heating Appliances KW Security Systems:1 4 No.of Water No.of No.of Devices or Equivalent Heaters KW Data Wiring: No.of Signs Ballasts 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 ectri al Work: 1p 0 (When required by municipal policy.) Work to Start: If" Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 [Z1 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties o jperjury,tha the information on this application is true and complete. FIRM NAME: r/)A I et* �",�'C p AV M, S 3 �� LIC.NO.: O l Licensee: Signature (If applicable,en er"exempt"in the license number line LIC.NO.: Address: VS- /V r a17,n/.v e'S e /ac /, Bus.Tel.No.: '7 7 f® S3/ *Per M.G.L.c. 147,s.57-61,security work requires Department of b is Safety"S"License: Alt.LiTe.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 ■ owner • own ' :ent. Owner/Agent Signature Telephone No. PERMIT FE $ 50. i!