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Home My WebLink AboutBLDE-23-002702 .w- Commonwealth of Official Use Only 'E Massachusetts Permit No. BLDE-23-002702 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:11/15/2022 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) 1170 GREAT ISLAND RD Owner or Tenant CURTIS UTEBRANZ Telephone No. Owner's Address 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 0 Undgrd EI No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New garage(3 car)feeders from main 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- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No,of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jay A Donnelly Licensee: Jay A Donnelly Signature LIC.NO.: 15717 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 158 PINE ST, RAYNHAM MA 027671121 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: $75.00 ( 6# - a/.f j tt(t7( r G-)U6C4 511E z3 .6/a. ( [24 3 RECEIVED .. .1. eiVassaskuseas Official Use Only }. • NOV 15 20 3 Z7 ' o� i�,r. Permit No. .Z �/ Q'� E ¢ -UILp�-ING-'DEPARTME T Occupancy and Pee Checked a D� r'ems' ' 1 ON REGULATIONS Rev. (tom 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 ALL INFORMATION) Date: //—ID,Z2 City or Town of: g/ t To the Inspector of Wires: By this application the undersigned gives notice of his or her intentkm to perform the electrical work described below. Location(Street&Number) r//7D &�,. r / i /4, Owner or Tenant.C�ijIe /-fz 5 /Q 02 Telephone No. Owner's Address c#A744r441r, 11.2 (1 l "TE,VEy� 79o3 nj Is this permit in conjunction with a permit? Yes No El (Check Appropriate Box) Purpose of Building Gila Utility Authorization No. Existing Service olpt,Amps /ggVolts Overhead 0 Undgrd(32r No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity 3 "eel Location and Nature of Proposed lyrical Work: ! id , ?CAA Lt.) s>a e i Fkm Fp" •0gE • kti Completion oft efollowrngtbk Istv be waived by the/ of Wire . tli No.of Recessed Luminaires No.of Celt-Slap.(Paddle)Fans Transformers n No.of Luminaire Outlet No.of Hot Tubs Generators KVA 47 No.of Luminaires 0 swbundeg peelAbove 0 In- El tto.of i mer L tli. tired. Bfht *UnHs ignting No.of Receptacle Outlets 0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 42 No.of Gan Burners `No.of Detection and Initiating Devices l` al No.of Ranges No.of Air Cond. T No.of Alerting Devices No.of Waste Disposers Number Tons KW NoDe Acting Devices , No.of Dishwashers SpaedArea Heating KW Local 0 t''t 0 Other No.of Dryers Security Systems:** No.of Water , NHe.of aftag Appliances KW off No,of Devicesor UnivalentBeaten SignsBallastsData o,of De Ices or No.Hydromassage Bathtubs No.of Motors Total HP Tel mf Devices or Ea OTHER: ?,,„1-00- Attach detail or as required by Ike for of Wirer. Estimated value of Electrical Work: C4 (When required by municipal policy.) Work to Start.///0—aZa2.. Inspections to be requested in h3corchince with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit far the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial ntial equivalent The undersigned certifies that such co is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE kEr ND 0 OTHER 0 (Specify:) I cent ,under t rdne and penakies of, , , that the information on this application is awe and complete FIRM NAME: VnAMA-11 Ejtrzygre. LIC.NO.:R.57/7 Licensee: ' i a � ' LIC,NO.: (If applicable.��A _ t" license member Ens.Tel.No.: P9�-2.v7-(%/3 Address: *Per M.G.L.c. 147,s.57-61 �work requiresof Public "S" Ai�t.Tel.Na. �N Department Safety 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)0 owner 0 owner's agent Owner/Agent Signature Telephone No. I PERMIT FEE:$