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Home My WebLink AboutBLDE-22-006872 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-006872 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 ate:5/27/2022 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DTo the Inspector of Wires: City or Town of: YARMOUTH � By this application the undersigned gives notice of his or her intention to perform the electrical work described below. � ✓`.J Location(Street&Number) 22 CAMPION RD Telephone Pfo Owner or Tenant VERMETTE RICHARD R ) Is this Owner's Address VERMETTE KIM B, 22 CAMPION RD,YARMOUTH PORT, MA 0 Utility Authorization 2675❑-1560 (Check Appr mate permit in conjunction with a building permit? Yes 0 No. Purpose of BuildingNo.of Meter Existing Service Amps Volts Overhead 0 Undgrd 0 New Service Amps Volts Overhead 0 Undgrd 0 No.of Meter Number of Feeders and Ampacity .,- ? Location and Nature of Proposed Electrical Work: Install generator /^Ns Completion of the:following table may be waived by the Inspector of Wires. No.of Total No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Recessed Luminaires KVA 20 No.of Luminaire Outlets No.of Hot Tubs Generators 1 Above ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ In-grnd• Battery Units No.of Oil Burners FIRE ALARMS I No.of Zones No.of Receptacle Outlets No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Alerting Devices No.of Ranges No.of Air Cond. Tons Heat Pump I Number I Tons I KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Local 0 Municipal Space/Area Heating KW Connection 0 Other: No.of Dishwashers Security Systems:* Heating Appliances KW No.of Devices or Equivalent No.of Dryers No.of No.of Ballasts Data Wiring: HeNo Water KW Signs No.of Devices or Equivalent Heaters cations Wiring: i Telecommun No.Hydromassage Bathtubs No.of Motors Total HP Tel ommuns ar Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of ires. 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, coveragepermit or its the substantialequivalent.Theundersigned certifies unless that she ack covecensee rage proof of liability insurance including"completed operation" is in force,and has exhibited proof of same to the permit issuing office. S ecif 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: John H Brewer LIC.NO.: 14092 Signature Licensee: John H Brewer Bus.Tel.No.: A applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:205 CEDAR ST,W BARNSTABLE MA 026681324 *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❑theoli liability insura owner csoverage normally required by law.But my signature below,I hereby waive this requirement.I am the(check one) Owner/Agent Telephone No. PERMIT FEE: $50.00 Signature ��,,II y�j} Official Use Only Commonwralth o�//1 f e Permit No.0124 7 Z PY �t c� ai. .Uepartmsnt oil firs�srvices Occupancy and Fee Checked e BOARD OF FIRE PREVENTION REGULATIONS v.yAf �Re 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Electrical Cakc All work to be performed in accordance with the Massachusetts (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,> 3 fl City or Town of: 2 ��—✓�' the electrical wo described below. By this application the undersign gives notice of his or her� in the I actor Wires': on to perform Location(Street&Number) Q/-7 !/cyAl / ( K y 10 =i <1 Telephone No.S' "'.'{ ., Owner or Tenant � � � �/ ` Owner's Address 0 Nod (Check Appropriate Box) Is this permit In conjunction with a building permit? Yes Purpose of Building R r�f )A/ (& U,fry Authorization No. �� . :31 olts Overhead Undgrd 0 No.of Meters Existing Serviee.cs.Lsc. Amps ✓� No.of Meters New Service Amps / Volts Overhead ElUnd d In 0 Number of Feeders and Ampacity -. Loot 'on and Nature of Proposed Electrical Work: la1457;4L.,L C�Y1-1�- �' l�`� �' c y • (A4 �t G e--.. of r 7 e ` the Inspector ofWires. Ir., Completion of the foilowinVableo g be waived by nspec l No.of Ceti.-Soap.(Paddle)Fans Transformers Total No.of Recessed Luminaires �A No.of Hot Tubs Generators No.of Luminaire Outlets No.of Lmergency Lighting Above In- a IC- No.of Luminaires Swimming Pool mod.Above ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and " No.of Switches No.of Gas Burners Initiatin Devices ` o of Alerting Devices 1 No.of Ranges No.of Air Cond. Tons No. eat ,um um, ons.___.' '._ `o.0 1 ontain'. p _'-----^r Detection/Alertin i_Devices No.of Waste Disposers Totals: . Local El p; No.of Dishwashers Space/Area Heating KW Conneunction 0 O 'Security Systems: * No.of Dryers Heating Appliances KW No.of Devices or E'uivalent o.o Data Wiring: `o.o` "stair °'°Heaters Si�is Ballasts No.of Devices or '.uivalent No.Hydmmasag e ecomm i a. i ns '.+ is e Bathtubs No.of Motors Total HP No.of Devices or uivalent O rHER: the Inspector of Wires. Attach additional detail if desired.or as required by Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 coverage is in force,and 0 }f of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER this application is true and complete. I certify,under the pains and penalties of p rf ry,that the infoon LIC.NO.: FIRM NAM : LIC.NO.:�J�� j (rt/af Signatur �f p� CJ J (¢ Licensee: e, ✓ , ,, 5F Bus.Tel.Nose A applicable,enter"exempt" the is e numb Line r. � Cf 1 Alt.Tel.No.: Address ��.' ` I�� t rSafety"S"License: Lic.No. *Per M.G.L.c. 147,s.57-61,security work requires Department of Publiliabity OWNER'S INSURANCE WAIVER: I am aware that the Licensee nons I�e(che k lne)i❑owner o❑owner's ally required by law. By my signature below,I hereby waive this requirement. Owner/Agent Telephone No. PERMIT PEE: $ Signature