The URL can be used to link to this page

Home My WebLink AboutBLD-23-007429 a Commonwealth of Official Use Only �;. ') Massachusetts Permit No. BLDE-22-007429 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:6/27/2022 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) 11 CADET LN Owner or Tenant DRISCOLL JAMES P JR 0 Telephone Owner's Address 11 CADET LN,WEST YARMOUTH, MA 02673 ' , -%, Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • 4. i • e !', Purpose of Building Utility Authorization No. Existing Service Ampsn P Volts Overhead 0 Undgrd 0 No.o . ' 4 - New Service Amps Volts Overhead 0 Undgrd 0 No.of M: . Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Generator 4 '' Completion of the following table may be waived by th p ctor 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 g bove ❑ gr ElNo.of Emergency Lighting rnd :rid. 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 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 Water No.of Devices or Eauivalent Heaters KW No.of No.of Ballasts Data Wiring: Siens No.of Devices or Eauivalent 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: Signature LIC.NO.: !If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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) ❑ owner 0 owner's agent. )wner/Agent iignature Telephone No. PERMIT FEE: $50.00 I RECE1V_ —D ` �D. �c�` '. ` 22 2022 /&di yyj aaeac ueo `,^ ': ito Official Use Only It M„ , DEPARTMENT spartnu,tE o/`� s'.w�se Permit No,�Z'Z=zL-ZQl ' = BARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFORMRev. 1/07] leave blank —"— All work to be performed in accordance with the Massachusetts Electrical ELECTRICAL WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) I Code(NEC),527 CMR 12.00 City or Town of: YARMOUTHDate: By this application the undersigned gives notice of hi r her intention to pea.rm the electrical To the Inspector work described below. Wires: Location(Street&Number) `", tn Owner or Tenant J�r ! Owner's Address Ala' . ,'At' ' J one No. -,L P, -q (� -6 Is this permit in conjunction with a building permit? I r •1�► Purpose of Building Yea 0No (Check Appropriate Box) Existing Service_ Utility Authorization No. New Amps /--'Volts Overhead IDUndgrd rvice Amps / EliNo.of Meters Number of Feeders and Ampacity —''dolts Overhead C] Undgrd Location and Nature of Proposed Elect ❑ No.of Meters rlcal Work: f V' ^!�' No.of Recessed La Com.letiwr o the o!lowin• table m v Luminaires No.of Cell:Sus be waived b the Grs,ector o No.of Lumiaaire Outlets P (Paddle)Fans �0.o Wires. No.of Hot Tubs Transformers a l' No.of Luminaires KVA SwimmingPoolGenerators KVA • 1 ove n- No.of Receptacle Outlets 'rnd• ❑ nd. ❑ °•a Units mergency g mg No.of Oil Burners Batte Units of ti^ No.of Switches FIRE ALARMS No. No.of Gas Burners Zones ` No.of Ranges o•0 r etec on an, No.of Air Cond. InitYatln_ Devices No.of Waste Disposers 'eat ' Tons No.of Alerting Devices ump um,er Totals, ......_.........._.......... No.of Dishwashers ns "..IM 'o.° e - onta ne Detection/Alertin• Devices No.of Dryers Space/Area Heating KW 'un c Heating Appliances Local 0 Connection 0 Other 'o.o "a er KW ccu ty stems: Heaters KW 0•o No.of Devices or E uivalent Si,ns , l a Data Wiring: No.Hyd He assage Bathtubs Ballasts No.of Motors No.of Devices or E.uivalent OTHER: Total HP a ecommun ca,ons " r ng: No.of Devices or E,uivalent Estimated Value of Electrical Attach additional detai!lfdeslred,or Work to Stan. Work' as required by the inspector of Wires. Inspections to be requested tedhin'required by municipal policy.) INSURANCE COVERAGE: waived by q accordance with MEC Rule 10,and upon completion. licensee provides liability sinsurance including he0er,no e theun licenseed provides es that proof ofh coverage si in insurance , ud has"completed operation" performance of its subs al work may issue unless 'combited pro a fof a"c to ee er substantial of equivalent. CHECK ONE; p of same to the permit issuing ofFice The I cerNjy, tarpains and INSURANCE sOo O 0 OTHER FIRM N IPer u (Specify:) under i ry,that the information on this application pplication is true and compete. (!f nppllcable,enter"exempt"in the license member Jlt7e/ Signature LIC.NO.: Address: LIC.NO.:-- *Per M.G.L.c. 147,S.57-61,secure w This. OWNER'S INSURANCEty work requires Dc aTel.No. WAIVER: I P �trnent of Public Safety"S"License: Alt.Tel.No,:Owner/Aedgent g law,.. am aware that the Licensee does not have the liability insurance coverage no� Owner/Agent 'my signature below,I hereby waive this requirement Lic.No. Signature "U4`�-�' � I am theJcheck one � owner Wally Telephone No.�� ( owner's a:ent. PERMIT FEE: $