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Home My WebLink AboutBLDE-22-005828 si, Commonwealth of Official Use Only ttli:— 4 Massachusetts Permit No. BLDE-22-005828 , , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/12/2022 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) 1214 GREAT ISLAND RD Owner or Tenant Barbara Kates 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 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 basement in guest house. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 10 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 13 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: 1 5.8 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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: 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 a)-Ceij *t/2o7zv .V RECEIVE ® '` APR 1'2 2022C0 ....,,k el v7.4eisa w a.11e Official Use only ,. .7 Permit No. S12_-sg 26 I ----- . at oft S•. alp •"LDING DEPARTM . 1° Occupancy and Fee Checked k '. rVited ii, ,;,,„.,�' ---.. = . • "REVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: // al.o2. City or Town of: )4F/ovrii To P the I e or of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&N Haber) /eg/`° Gte . /I4kJ /el). Owner or Tenant /j% A A s i s A ff Telephone No. i�� ' i 7. /si , .1 i&if. Owner's Address �l�Il� / i/r ��,.> •y r_ .i r r Is this permit in conjun n with a building permit? Yes I No ❑ (Check Appropriate Box) e a fr r Purpose of Building (SX%7F/Vfg Utility Authorization No. Existing Service /41 Amps Jo111/ay6Voits Overhead 0 Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity a 002 \ Location and Nature of Proposed Electrical Work: x i (4/5i/11L/lJT as? Stf%. / Completion of the fillowinktable may be waived by the Inspector of Wires. No.of Recessed Luminaires /0 No.of Celt.-S (Paddle)Fans No.of Total Transformers KVA No.of Limbo**Outlets No.of Hot Tubs Generators 74 KVA Above In- ivo.of mergency Lighting *e No.of Lalmbudres i Swimming Pool end. ❑ grad. ❑ lu Battery Unite No.of Receptacle Outlets `,,,% No.of 011 Burners FIRE ALARMS No.of Zones n and No.of Switches No.of Gas Burners �No.innitiatf ingQDevices 1 i i No.of Ranges No.of Air Cond. Top i No.of Alerting Devices No.of Waste Heat PumpNum r Tons KW No.of Self-Contained Disposers Totals: ..._7 ........... .._...- r.i ..�,._ Detection/AIe tini Devices al r-i No.of Dishwashers Space/Area Heating KW LocalL Con inectip oMunicn u Other No.of Dryers Seca Heating Appliances KW No o Systems:*f Devices or Equivalent No.of Water , No.of No.of Data wiring: / Heaters Signs Ballasts No.of Devices or Equivalent No.Hydro 'Teiecom massage Bathtubs No.of Motors Total HP No.ofm Devicesnnicaifons or'EgnivbinSeent i^ OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lee ical Work: (When required by municipal policy.) Work to Start: / , Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O 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 covvge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER El (Specify:) I certify,under the pains andAtrenaldes ofperjury,that the Information on this application is true and complete. FIRM NAME: -1,As er/1/JUE//r C/EL7g2G� LIC.:NO.:A/J1/7 Licensee: 'SAN( QOI)thc 11 ti Signature LIC.NO.:E Yea p� (If applicable,enter"exem in the license ber ine.) Bus.TeL No.. T 3 Ii --GO Address: /5-8 /t� Jr-7'.7' oeifyA ill.pof j /41 A 0$27e, Alt.Tel.No.: . -' s.. y .25" *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent I PERMIT FEE:$ Signature Telephone No.