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Home My WebLink AboutBLDE-22-005669 Commonwealth of Official Use Only fi- Massachusetts Permit No. BLDE-22-005669 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:4/5/2022 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. ,9'., FA,c, .o .,R Location(Street&Number) 18 KEARSARGE RD r'.s• "1 Owner or Tenant Matt Ryalls Telephon "� , �„ 4 I . lib Ns:i A i a'""A Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro�rtiate$oxr Purpose of Building Utility Authorization No. 'tv r. i.,, Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters`` .J New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Shy <,i Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: Replace devices&breakers as needed.Replacement furnace. ��Z Completion of the following table may be waived by the Tinspector 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 40 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 20 No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Tons Tot No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Cct M n eunis palln 0 Other: No.of Dryers Heating Appliances KW Security Systems:* 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 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: Collin Braley Licensee: Collin Braley Signature LIC.NO.: 11301 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 16 CHURCH ST, NORWELL MA 020612732 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: $80.00 RECEIVED APR 0 4 a of 1/Iaddachadsdld Official �� " Permit No. C5 7 ` fit" BUILDING D CPA s ENT o uw srvicsd -- 'a I r By _ Occupancy and Fee Checked _ =40 • - = -'•-_-----• ENTION REGULATIONS fRev. 1/07] (leave blank) c..) APPLICATION FOR PERMIT TO PERFORM ELEC RICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MC), 27 CMR 12.00 0 O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Li if ZZ_ City or Town of: YARMOUTH To the Inspecto of Wires: ' By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 2� K642 4(z c 1Lb Owner or Tenant NAT J Alia1LS Telephone No.77 i-73 I-/lo7Z E Owner's Address 2: 1,A7 CAM /ZD >L iNc,S7-a,J Q Is this permit in conjunction with a building permit? Yes ❑ No vi (Check Appropriate Box) Purpose of Building Dk,43LuNc, Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters , } New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters --3 Number of Feeders and Ampacity q i Location and Nature of Pro os Electrical Work: jlGP(.t s yIc £ g9_014.fa A 5 Nt'vl9D 1)j a, N6w LtOniA( i 'J k 1 Completion of the following table maybe waived by the Inspector of Wires. t s No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total of Transformers KVA _ '"t No.of Luminaire Outlets No.of Hot Tubs Generators KVA eA l No.of Luminaires swimming Pool Above In- No.of Emergency Lighting g grnd. ❑ Bernd. ❑ Battery Units _ �:} No.of Receptacle Outlets t p No.of Oil Burners FIRE ALARMS No.of Zones µ= No.of Switches Zp No.of Gas Burners No.of Detection and _ _ Initiating Devices Ili No.of Ranges No.of Air Cond. Total No.of AlertingDevices 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❑ Municipaonnectionl ❑ otherC 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 Ele trical Work: 1) O 60 (When required by municipal policy.) Work to Start: 4 Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 RI 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: J J 02TT4 51:A t (U Cii 1(A L Co NTAA Cr. NO.: 20 3,S-A Licensee: Cu Lt-1,j '(Ut 1_,1 Signature ,(�1. , A LIC.NO.: Li 3 01 - 13 (If applicable,enter"exempt"in the icense number line.) Bus.Tel.No.508 ?g 8 9k9z Address: 1S C. )�T (2-11k UNIT1 Pi-Y4A4 1M NtA Alt.Tel.No.:'ISi 6W 074S CauINS chi.) *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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 ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.