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Home My WebLink AboutBLDE-23-004967 or Commonwealth of Official Use Only p �; ,i Massachusetts Permit No. BLDE-23-004967 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:3/9/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention erform th electric I work describedbe ow. Location(Street&Number) 56 NORTH RD t y�� C_F 1 D[ Owner or Tenant D Telephone No. Owner's Address , 56 NORTH RD,WEST YARMOUTH, MA 02673 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: Heat pump&air handler. 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 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. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: 1 Detection/Alertine 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 Eauivalent Heaters KW No.of No.of Ballasts Data Wiring: 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: Licensee: Austin Duty Signature LIC.NO.: 56947 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7742682344 Address: 10 Mercury Drive,South Yarmouth MA 02664 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: $50.00 A ( ( -z- m_ 0 14 r`J l.ommonw•a&el y1?adeaenwe tte Official Use Only �•pat#trm,d o f &,vitas Permit No. `'C (4p l J }4 r BOARD '7 Occupancyand Fee Checked N OF FIRE PREVENTION REGULATIONS [Rev. I/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: (3 / ' /2,3 City or Town of: q0 y Yl To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to Location(Street&Number) perform the describedelectrical work described below. d �� Noc'k1n r weS�- 1l tccnou t,h Owner or Tenant -p U e I And-cm Owner's Address 6 Telephone No.'7�]/�_g68—Q3 2 y ' S Noc. - �rl . � ya(''c`naurh NSA 0 Z6 7 3 � Is this permit in conjunction -r1 with a building permit? Yes U No FA (Check Appropriate Box) Purpose of Building Dwe 11 Utility Authorization No. en ExistingService 1 0 0 Amps NIZ y()vola Overhead CI Undgrd ElNo.of Meters New Service Amps / Volts Overhead Number of Feeders and AmpacityAn 0 Undgrd❑ No.of Meters Locations and Nature of Proposed Electrical Work: 1A;re an, h ano ter ;n 40,1_,,`L! a nr4 cum? Q -w\e , tli`t Completion(Pile followin table my be waived by the!npectorof Wires. No.of Recessed Unalaska No.of CAL-Soap(Paddle)Fans Ge o.of Trmen otal No.of Luminaire Outlets No.of Hot Tubs Genneraeraotoorrs KVA No.of hnminalres Swimming Pool Above [] In- i o.or Emergency Lighting 'z1 No.ofgrad. vat ❑�Battery Units Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS JNo.of Zones No.of Switches /... No.of Gas Burners t 1�Ta of Detection and l ' Na of RangesTotal Devices No.of Mr Cond. Tons No.of Alerting Devices Na of Waste Disposers Heat Pump I Number Tons ) W 'No.of Contained Tom: "--(.. _� ..___._�__ ..___ Detection/Me Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal No.of Dryers HeatingConnection ❑ "am Appliances KW Security Systems:* No.of Water , No.of No.of No.of Devices or Equivalent Heaters S s Ballasts Data Wiring. No.Hydromusage BathtubsNa of Devices or uivalent No.of Motors a mm " � OTHER: S co !1 Lk Total HP Na of Devices or Equivalent �n a14A, 4- Ou-t-Sy►� Estimated Value of Electrical Work: Attach addittonat detail l desired,or as required by the In spector of Wires. Work to start: 3 'Z (When required by municipal policy.) INSURANCE CO Inspections to be requested in accordance with MEC Rule 10,and GE: Unless waived by the owner,no permit for theupon cmpletion the licensee provides proof of liability insurance including`completedperformancecoverage of itssub electrical work may issueent. unless undersigned certifies that such coverage is in force,and has exhibited operation" tothe or substantial equivalent. The CHECK ONE: INSURANCE I' BONDproof of same to permit issuing office. I�h',under the 0 OTHER 0 (Specify:) pains and penalties ofpeynry,that the information on this FIRM NAME: e e SS application is true and completes Licensee: Atis�- }.,/ signature LIC.NO.: 3 3ALth ((IIf apra�ble,enter exempt rn they license LIC.NO.: �o9L?7 number line.) -S Bus.TeL No.7 W.:'7 Z 7 *Per M.G.L.c. 147,s.57-til, ty workment Alt.TeL No.: OWNER'S INSURANCE WAIVER: I am aware that Licensee Public not thfety"S"License: 1 liability y insurance Na required by law. By my signature below,I hereby waive this requirement. I am the(check one II owner coverage n r Owner/Agent Signature ■ owne 's .:eat. Telephone No. PERMIT FEE:$