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Home My WebLink AboutBLDE-21-000713 Commonwealth of Official Use Only ' Permit No. BLDE-21-000713 E.. - Massachusetts 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:8/14/2020 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) 117 PAWKANNAWKUT DR c4-iq Aiarrik I Owner or Tenant J oN31`^iAI& - Telephone No. Owner's Address R€A 3 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 200 Amps 120/24( 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: Temporary service w/(4)20A GFI circuits 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 Inttiatinc Devices No.of Ranges No.of Air Cond. 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters 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 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: 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 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: $90.00 C4e,Si Q i Commonwealth of Massachusetts Official Use Only :_�=,� Permit No. -t�Uly '7 l 3 _>r Department of Fires Services �._'!!=y4 Occupancy and Fee Checked -- BOARD OF FIRE PREVENTION REGULATIONS (may 9/05) Cleave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M� CMR 00 (PLEASE PRINT IN INK OR TYPE ALL INFO ATION) Date: / City or Town of: /)1�. �1 y /To the Inspector of Wires: I By this application the undersigned gives not' of his or her intention to perform the electrical work described below: 3 Location(Street&Number) I !i TANA/ k r4i�nVA vt! K.0 1 T)2.-k-V Owner or Tenant -,mil 6 i4J^I F4-0 al I/ — Telephone No. 7)9 2Z g -iet J Owner's Address 'k Is this permit in conjunction with a building permit? Yes Dgt. No ❑ (Check Appropriate Box) Purpose of Building _ p.t`«� Utility Authorization No. (� Existing Services 2C4 Amps Le,e,_/,..249olts Overhead❑ Undgrd IN No.of Meters . 1 4 New Service Amps / Volts Overhead❑ Undgrd D No.of Meters n Number of Feeders and Ampadty r7 V t—L— 2 )C' Avi . I i 9 W S t:,P PG C ‘ Dr Location and Nature of Proposed Electrical Work: 6rf 4 a oA 1,-47 t 2G M� J 61 re i e.-12C..t. r r S -a ' 3c(1-4tc Completion of the following table Islay be waived by the Inspector of Wires. �.l No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans 7r Nloa of nssforrarenr Total tr No.of Luminaire Outlets No.of Hot fibs Generators KVA al No.of Luminaires Swimming Pool ode ❑ , ❑ go,i g.frienZencY Id) No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No. n and I��Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices t� Heat Pump Number . ..Tons.........KW No.of Self-Contained S No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Mt on ; ;Other * V No.of Dryers Heating Appliances KW No.Security Equivalent No.of WaterHSigns eatens KW No. No. Data Wiring: �t No.ofBallasts No.of Devices or Equivalent f] No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicationssw lent OTHER: Attached additional detail if desired.or as required by the Inspector of Wires. Estimated Value of ec� ical Work: (When required by municipal policy.) Work to Start: `� v v Inspections t 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❑ (Specify:) I certify,under the pains and penaltiesof perjury,that the inforttwaivn rs application is true and complete FIRM NAME: �I 1} t_ L j7 �L-L t 5 , - LIC.No./on 7/ 6 Licensee: Y.4 t'L—.-- Signature �J LIC.NO.: (If applicable,eJ�p�,,,ter"exemptn the license bet e.) _ Bus.Tel.No.: 7 7 (P r 3 1 1 Address: c in 0r_, rl , it — Alt.Tel.No.: *SecurityS tem Contractor License required for this work;if applicable enter the license number here: Y 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 ❑owner's agent Owner/Agent PERMIT FEE:$ Signature Telephone No.