HomeMy WebLinkAboutBLDE-22-006363 (\CA Commonwealth of Official Use Only
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i. Massachusetts Permit No. BLDE-22-006363
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:5/4/2022
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.
Location(Street&Number) 61 OUT OF BOUNDS DR
Owner or Tenant CAFFREY PATRICIA E Telephone No.
Owner's Address 61 OUT OF BOUNDS DR, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install generator
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 1 KVA 30
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
Initiatine 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 ❑ 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: Scott D Morris
Licensee: Scott D Morris Signature LIC.NO.: 18338
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:PO BOX 1264, HARWICH MA 026456264 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 j Telephone No. PERMIT FEE:$100.00
6(q I KZ (M7 GA.s 4 AJ r Mae(?)
Commonwealth of Massachusetts Official Use Only
r 1 - t Permit No.
R E ,t : � E 0 Department of Fire Services ZZ
Occupancy and Fee Checked
MAYy�"' 022 OARD OF FIRE PREVENTION REGULATIONS
[Rev. 1/07] (leave blank)
__ ___ APPLI ATION FOR PERMIT TO PERFORM ELECTRICAL WORK
BUILDING D E PA RTM E Ndll work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
ay.
CEASE Pier- 7N INK OR TYPE ALL INFORMATION) Date: 05/03/22
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) 61 Out of Bounds Drive
Owner or Tenant Partyka Telephone No
Owner's Address
Is this permit in conjunction with a building permit? Yes ® No
❑ (Check Appropriate Box)
Purpose of Building Residential Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps Volts Overhead ❑ Undgrd g ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work Rough and finish wiring for 30kW standby generator.
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. gmd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
Tot
No.of Ranges No.of Air Cond. Tonal
No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I Tons JKW No.of Self-Contained
Totals: r Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑
Other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of No.of Devices or Equivalent
Heaters KW No.of 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: 05/03/2022 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 o same to the permit issuing office.
CHECK ONE: INSURANCE N BOND 0 OTHER 0 (Specify:
I cert , under the pains and penalties of perjury, that the information • is application is tr and complete.
FIRM NAME: SDM Electric,Inc.
LIC.NO.: 18338A
Licensee: Scott D.Morris Signat / /
(If applicable,enter "exempt"in the license number line.) ` It�� IC.NO.: 38090E
Address: PO Box 1264 East Harwich,MA 02645 Bus. el.No.:Alt. Tel.No.: 7508
74 430 4014
*Per M.G.L.c.147,s.57-61,security work requires D:•. - t of Public Safety"S"License: E ail:scottmorr s@sdmelecctrriic.om
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally re-
quired by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $ I
` SDM Electric, Inc.
P.O. Box 1264
East Harwich, MA 02645
Phone 508-430-4014 Fax 508-430-4015
Request for Electrical Inspection
Town of: Yarmouth
Date:May 3,2022
Date of inspection requested: May$2022
Owner: Partyka
Job Location: 61 Out of Bounds Drive
Electrician&phone#:SDM Electric,Inc.508-430-4014
Permit#and date of issuance:
Type of inspection:p
Trench(time trench will be open)
X Rough Wire (THROUGH BASEMENT UP TO ATTIC FOR GENERATOR)
Service
Final
Other
Someone will be present X No one home,O.K.to enter (BULKHEAD UNLOCKED)
_X Special Instructions: Please contact 508.430.4014 or 774.353.6902 with inspection results. Please fax any
corrections to 508.430.4015