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Home My WebLink AboutBLDE-23-03702 Commonwealth of Official Use Only , tN% 4 Massachusetts Permit No. BLDE-23-003702 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:1/9/2023 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) 271 SETUCKET RD Owner or Tenant BUTKA PAUL C Telephone No. Owner's Address BUTKA SUSAN A, 8 HUBLEY LN, SOUTHBOROUGH, MA 01772-1991 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Attic renovations Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 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 1 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton 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.of Devices or Eauivalent 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Jon T Moreau Signature LIC.NO.: 22967 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Redberry lane, MARSTONS MILLS Ma 02648 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. I PERMIT FEE:$75.00 1 1 /I1/,23 _ C 0mm0nwea[th o`///aeeackiesib Official Use Only �/� E ).. • •, Permit No. '.� i ✓,X� O .pa. ,,.ad sw ': Occupancy and Fee Checked v BOARD OF FIRE 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: 1/6/2022 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)rf J Setucket Rd Owner or Tenant Paul & Susan Butka Telephone No. Owner's Address 271 Setucket Rd Yarmouth Port MA 02675 4 Is this permit in conjunction with a building permit? Yes V No ❑ (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead 0 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: Minor Electrical For Attic Space Turned Into Storage t. Completion of the followinktable may be waived by the Inspector of Wires. tij No.of Recessed Luminaires 3 No.of Ceil.-Soap.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones �� No.of Switches 1 No.of Gas Burners No.of Detection and Initiating Devices 1 LI No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number T . KW No.of Self-Contained Totals: - offs .__..___.._ Detection/Ale . Devices No.of Dishwashers Space/Area Heating KW Local❑ Mnn w O o 0 t� _ Cyonnection No.of Dryers Heating Appliances KW Security of Devices or Equivalent No.of Water , Heaters Signs Ballasts No.No.of No.of Data Wiring: Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications or Egquiv ent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 2500.00 (When required by municipal policy.) Work to Start: 1/9/2022 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 collage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cerdfy,under the pains and penalties of perjury,that the information on this application is true and cos+rplete FIRM NAME: Coastal Mechanical LIC.No.: 8082A1 Licensee: Jon T Moreau Signature AL 711/9 44, LIC.NO.: 22967-A (If applicable,enter"exempt"in the license number fate.) Bus.TeL No.:508-737-8747 Address: 21L Fruean Ave S. Yarmouth MA 02664 Alt.TeL No.:506-326-9699 *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)0 ownerowner's Owner/Agent0 agent. Signature Telephone No. I PERMIT FEE:$75.00 I