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Home My WebLink AboutBLDE-23-005949 Commonwealth of Official Use Only •%.—.5,7 0:\-- Massachusetts Permit No. BLDE-23-005949 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:4/27/2023 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) 173 PINE ST Owner or Tenant MILLER EDWARD M Telephone No. Owner's Address MILLER MARY ANN, 173 PINE ST,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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: Wiring for shed with trench to house. 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- ElNo.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 Ton No.of Waste Disposers Heat Pump Number Tons J KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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: Ray W Bombardier Licensee: Ray W Bombardier Signature LIC.NO.: 33621 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 2443, MASHPEE MA 026498443 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 5(3/24-5 /r7 C *.r- `j t RECEIVED DR 26 2023 onvtwnweattlr.o`Maddarhudetio Official Use Only Y Permit No. ..� 2- 5cg r(" s`,z_,_ ZParimsni of ire norvresd , t1 ,- NG DEPARTMENT � �.ii BOARD DF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/071 leave blank _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod ( EC),52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector }'Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant 1--"'p c a_ ov - a 1 Owner's Address l 3 I jv 2 Telephone No.g2-- c j lP a � OCR 7 -7 .._- 1 Is this permit in conjunction with a building permit? yes �-�, � Purpose of Building_` � NO ❑ (Check Appropriate Box) Utility Authorization No. Existing Service�� Amps / O Volts / Overhead❑ Undgrd No.of Meters _ _____ New Service Amps _/ Volts Overhead Number of Feeders and Ampadty �v ❑ Undgrd[� No.of Meters Location and Nature of Proposed lectrical Work vi Completion o the allow in_ table m be waived b the In ,ector o Wires. ii,; No.of Recessed Luminaires / No.of Ceil:Snsp.(Paddle)Fans °�° ota '=t No.of Luminaire Outlets Transformers KVA rz No.of Hot Tubs Generators KVA t' No.of Luminaires Swimming Pool ' •'ove n- nd. ❑ ,°'o mergency g mg a � nd. ❑ Bane Units M; No.of Receptacle Outlets No.of 011 Burners `�=- FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'o.o etec on an a No.of Ranges Initiatin Devices il No.of Air Cond. ota No.of Waste Disposers 'eat 'ump `um a er n Tons , �� No.of Alerting Devices Totals: o.o e - onta ne a No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local 0 'un c paon 0 otherNo.of Dryers Heating Appliances KW ecu ty Cystemst o.o "a er 'o o No.of Devices or E a uivalent Heaters ' ° ° Data Wiring: Si ns Ballasts No.of Devices or E a uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca•ons " rmg: OTHER: No.of Devices or E•uivalent Estimated Value of lectrica Wpm C� Attach additional detail if desired,or as required by the Inspector of Wires. to Start: (When required by municipal policy.) WorkSURANCE e9-T) a�` Inspections to be requested in accordance with MEC Rule 10,and upon completion. VERA E: 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 certify,under the pains and penalties ofpe 0 OTHER 0 (Specify:) FIRM NAME: rfu ,that the information on this application is true and complete. r� J t,..., 0-0A l`E-Z— Licensee: LIC.NO.: _ ( l (If applicable,enter"exempt"in the license number line. Signature Address: (� t LIC.NO.: ��3 fM 1H C Gz c YV /� a� i Bus.Tel.No.. %Zka. *Per M.G.L.c 147,s 57-61,security work requires epartment of Public Safety"S"License: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage No.: required by law. ByLic.No. Owner/Agent my signature below,I hereby waive this requirement. I am the(check one normally Signature � owner ■ owner's a,ent. Telephone No. PERMIT FEE:$