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Home My WebLink AboutBLDE-23-000267 Commonwealth of Official Use Only 14�t�' Massachusetts Permit No. BLDE-23-000267 % 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:7/18/2022 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) 155 STATION AVE Owner or Tenant STOOKSBURY SANDRA J Telephone No. Owner's Address 155 STATION AVE, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ 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 ON 0 Undgrd 0 pl4.)„Vlet r `V _ _. Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install 50 amp receptacle. (`�'. ,,, Completion of the following table may be war4e�T by th@Inspe�tofr 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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 Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs 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: WILLIAM S STADELMANN Licensee: William S Stadelmann Signature LIC.NO.: 18348 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 17 BECCA LN, MIDDLEBORO MA 023464018 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 CommonweanA ol MaekfaChit6ett.4 -, j__• _ffcial Use Only . Permit No. 7----S—C (-4----)7 7,7:7464, 2oparttnent of t.7in:Sdruice4 t Iiivi,7 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] ,i (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--(1-0.0 .0,- - City or Town of: 'lac rfkokAlr, 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) I b 5 S+cut 1 1-.) Ave Owner or Tenant 'Rabe_CC_CL. Stooks bi.)n Telephone No.SCYZ•. (o0- VE IS w 0 i:er's Address 1SS Sta-kl'6(\ A,)e_. , S . Yoo-TINOLAIkhnf , C,/ (01/41 --3-0 ly Is this permit in conjunction with a building permit? Yes E No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service— Amps / Volts Overhead E Undgrd E No.of Meters New Service Amps I Volts Overhead C Undgrd 0 No.of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i(\,--kex\\ 5b -0,‘, 1"eS (350 -Vt) A c\e cyla_c_6_ : 4„ V-) Completion of the following table may be waived by the Inspector of Wires. ..v No.of Total tit No.of Recessed Luminaires No.of Cell-Susp.(Paddle)Fans Transformers KVA CI Qs No.of Luminaire Outlets No.of Hot'rubs Generators KVA 4.-t. Above r-i In- ri No.ot Emergency Lighting -t° No.of Luminaires Swimming Pool grnd. 1--1 grnd. I--J Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones .., .t., No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total II,! No.of Ranges No.of Air Cond. No.of Alerting Devices Tons Heat Pump Number Tons IKW No.of Self-Contained . No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 lounnnieccilialon 0 Other No.of Dryers Heating Appliances KW Security Systeps:*No.of Devices or Equivalent No.of Wlaiteearters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent fTelecommunications VViring: No.Hydromassage Bathtubs INo.of Motors Total HP I No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Eleco.kcal Work ft ku\5 14') (When required by municipal policy.) Work to Start: 1-iS.'4- --- 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 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 informathT on this application is true and complete.Licensee: Ul11 ''\\r-P^ S--)adelview--(\ .S(, Signature _V- ,„_. ______,,,..---- tic.NO.: (If applicable, enter"exempt"in the license number lirie.) Bus.Tel No.:So$ U-.))-7-7 IS Address: PO fl)k. t lq 6 1,1‘..04al.,e bdr0 MA 0 1- 1 k. Alt.Tel.No.: *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)Ej owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ S U (I° I