HomeMy WebLinkAboutBLDE-23-003671 .o Commonwealth of Official Use Only
it. Massachusetts Permit No. BLDE-23-003867
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.1/07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 WORK
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION)
City or Town of: YARMOUTH Date:the Inspecto
17/2023
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.r of Wires:
Location(Street&Number) 66 WEST GREAT WESTERN R
Owner or Tenant
Owner's Address Telephone No.
Is this permit in conjunction with a building permit?
Purpose of Building Yes 0 No 0 (Check Appropriate Box)
Utility Authorization No.
Existing Service Amps P Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps Volts
Number of Feeders and Ampacity Overhead 0 Undgrd 0 No.of Meters
Location and Nature of Proposed Electrical Work: Install low voltage fire alarm system
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 KVA
Generators KVA
No.of Luminaires SwimmingPool Above In-
grnd. ❑
grnd. ❑ No.of Emergency Lighting
No.of Receptacle Outlets Battery Units
No.of Oil Burners FIRE ALARMS No.of Zones 3
No.of Switches No.of Gas Burners No.of Detection and 7
No.of Ranges Initiatine Devices
No.of Air Cond. Total
Ton No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons
Totals KW No.of Self-Contained
No.of Dishwashers Detection/Alerting Devices
Space/Area Heating KW Municipal
Local ❑ P 0 Other:
No.of Dryers Connection
Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent 0
Heaters KW No.of No.of Ballasts
Signs Data Wiring:
No.Hydromassage Bathtubs No.of Devices or Equivalent
No.of Motors Total HP Telecommunications Wiring:
OTHER: No.of Devices or Equivalent
Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires.
Work to start: 01/19/2023 (When required by municipal policy.)
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
I certify,under the pains andpenalties o (Specify:)
fperjury,that the information on this application is true and complete.
FIRM NAME: AMERICAN ALARM&COMMUNICATIONS INC
Licensee: RICHARD L SAMPSON
Signature Tel. NO.: 1212
(If applicable,enter"exempt"in the license number line.)
Address: DBA ADVANCED SIGNAL CORP,297 BROADWAY,ARLINGTON MA 02474 Bus.lt. Tel.No.:::
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.
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:$45.00 I
et c �(e)(-z:s
Commonwealth of Official Use Only
L Massachusetts Permit No. BLDE-23-003671
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
VRev.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:1/5/2023
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) 66 WEST GREAT WESTERN R
Owner or Tenant Starbuck Construction Services Telephone No.
Owner's Address 176 Sudbury Lane,Hyannis,MA 02601
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)L
Purpose of Building Utility Authorization No. tr 666 'L-1 9 ( CP Ilk),!0/1/-'
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: New House with underground services
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 g boved. ❑ g rnd. ❑ No.of Emergency Lighting
rn 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/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No
No.of Devices or Equivalent
HeatersWater KW No.of No.of Ballasts Data Wiring:
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: EAV SOLUTIONS
Licensee: JEFFREY S DEROUEN Signature LIC.NO.: 22206
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:110 Hedges Pond Road,Plymouth MA
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.:
OWNER'S INSURANCE WAIVER:1 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:$180.00
I
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,,AN 0 3 2023 0{ � Official Use Only
{ o/.. ire C� Permit No. E-Z3 3�1j]/
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L'—_ �a I N C D E'er Occupancy and Fee Checked
__BOAR �Z: PREVENTION REGULATIONS [Rev. 1/07]
(leave blank)
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: 12/28/22
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)66 West Great Western Road
Owner or Tenant Starbuck Construction Services Telephone No. 508 827-7134
Owner's Address 176 Sudbury Lane Hyannis, MA
Is this permit in conjunction with a building permit? Yes Q No ❑ (Check Appropriate Box)
Purpose of Building House Utility Authorization No. 10604191
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service 200 Amps 120 / 240 Volts Overhead I I Undgrd Q No.of Meters 1
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: New house with a 200 amp underground service
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- 0 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
Total
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons }KW No.of Self-Contained
Totals:I i— _.._.-.._.--_.._
YDeeection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
No.of No.of
KW
Heaters Data Wiring:
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: Inspections 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 ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete
FIRM NAME: EAV Solutions, LLC LIC.NO.:860 Al
Licensee: Jeffrey Derouen Signature /Piz.ect¢ LIC.NO.:22206-A
(Ifapplicable,enter "exempt"in the license number line.)
Address: 110 Hedges Pond Road Cedarville, MA 02360 Bus.Tel.No.•(508)245-7155
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.No.:(781)589-5692
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
Signature Telephone No. I PERMIT FEE:$180.00 I
/v). /a. I