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Home My WebLink AboutBLDE-22-004479 1A0e Commonwealth of Official Use Only flE-; ►t Massachusetts Permit No. BLDE-22-004479 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:2/11/2022 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. Nam'-°"y Location(Street&Number) 108 BERRY AVE r, N�; .. Owner or Tenant SCHATZ KATHLEEN Telephone i i v Owner's Address 108 BERRY AVE,WEST YARMOUTH, MA 02673 4 ,C)e 4 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro• is #, Purpose of Building Utility Authorization No. <3) "✓✓ Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters :' New Service Amps Volts Overhead 0 Undgrd 0 No.of Met s ilk Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In ground pool. Completion of the following table may be waived y tector 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. 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 ❑ Municipal 0 Other: Connection 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 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR, S YARMOUTH MA 026641339 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: $85.00 r Tatrnikt241 ?Zo Q12401.1;1/14 S14 Commonwealth of�j �.-+ y //laddach gelid Official Use On �— 2epartmenf n S Permit N -1 _sty= f_tiro _IV—=_• ° Serviced Occupancy and Fee Checked _ !y-:.,�...: BOARD OF FIRE PREVENTION REGULATIONS 1 •ev. 1/07) eave blank ppc 1!+/�Z-tnit e� �-, .ter..-,.�.— — ---— . � ` " . ` i��►ii; r TO rEm'FORVI E—E-C; RICALW R All work to be performed in accordance with the Massachusetts Electrical Code C), Z7 WORK F( (PLEASE PRINT IN INK OR TYPE ) CMR l z.�o ALL INFORMATION) Date: // 02t9-- City or Town of: YARMOUTH To ires: By this application the undersigned gives notice of his or her intention to performthe the electrical tides nbed below. Location (Street&Number) /d Owner or Tenant y1 e Owner's Address Telephone No. Is this permit in conjunction with.a builds g permit? Yes ❑ No ❑ (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 Number of Feeders and Ampacity ❑ Undgrd ❑ No,of Meters Location and Nature of Proposed Electrical Work: Com letion o the ollowin table m be waived the Ins ector o Wires. No.of Recessed Luminaires No.of CeiL S (Paddle)Fans Tota No,of Transformers KVA No. of Luminaire Outlets No,of Hot Tubs KVA Generators KVA No,of Luminaires Swimming Pool Above la- o,o mergency ung grad. ❑ arid. Batte Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No,of Switches No,of Gas Burners o.of Detection and No.of Ranges Initiating Devices Na of Air Cond. Tons No,of Alerting Devices Heat Pump umber Tons o,of elf-Contain No,of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Lora! Municipal nic' al ❑ Other No.of Dryers � Connection Heating Appliances KW Security Systems:* No,of ater No,o No.of Devices or E uivalent Heaters K''4' o. of Data Wirin Signs Ballasts No,of De ices or E uivalent No. Hydromassage Bathtubs No,of Motors Total HP Telecommunications Wiring: OTHER; No.of Devices or E uivalent �� 2 Z Attach additional detail if desired or as required by the Inspector of Fires. Estimated Value of Electrical Work Work to Start: Z (When required by municipal policy.) Work to E O ctions to be requested in accordance with MEC Rule 10,and upon completion. 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 covw is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L� BOND ❑ OTHER I cerizfy, under the ai nd enaltte ❑ (Specify:) et.., the information on this application is true and complete. FIRM NAME: G 9 , Licensee: d G LIC.NO.:— /�n 171/F Signature LIC.NO.: (If applicable,ente�.�q�empt"in h license numb ne.J / Address: J a �J a Bus.Tel No.: s-'21 J "Per M.G.L. c. 147,s.57-61,security work requir Department o Publ Safe D Alt.Tel.No.: OWNER'S INSURANCE WAIVER I h "S"License: Lic. No. required by law. B am aware that the Li one 0 censee does not have the liability insurance coverage normally S Owner/Agented y my signature below,I hereby waive this requirement I am the(check 1ISignature � owner ❑owner's a ens Telephone No. . PERMIT FEE: S