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Home My WebLink AboutBLDE-23-005744 r. r Commonwealth of Official Use Only �;,� NI Massachusetts Permit No. BLDE-23-005744 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:4/14/2023 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) 12 ACRES AVE Owner or Tenant HYLAND JEFFREY A EXC Telephone No. Owner's Address 12 ACRES AVE,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: Upgrade grounding&bonding. 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. grad. 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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons J KW No.of Self-Contained Totals: Detection/Alertina Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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 ofperjury,that the information on this application is true and complete. FIRM NAME: Timothy J Mcdonald Licensee: Timothy J Mcdonald Signature LIC.NO.: 10788 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:62 Nobby Ln,West Yarmouth MA 026733523 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 cAct y iLo /2.4) 65 & �6 Sac c. Z) ,r- t- RECE - �d -ED i/l am-/" / //1' `� - APR 13 Q12,m Dn .ealth of Massachusetts pft_iFiak useeirlii rnondc �. * =,� Permit No.: i= >1 =. PAR ? ment of Fire Services Occupancy and Fee Checked: 0 : I' Li -1R PREVENTION REGULATIONS [Rev. 1/20231 `. ,,,* APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC42e 527 CMR 12.00 City or Town of: � YARMOUTH Date: I L 14 zOz-t To the Inspector of Wires:By this application,theC dersd gives notices of his or her intention to perform the electrical work described below. Location(Street&Nu b Z -.S Unit No.: Owner or Tenant: j Email: Owner's Address: /2 0 Phone No • Is this permit in conjunct• n w buildin permit?(Check appropriate box)Yes El No Permit No.: Purpose of Building: K S G Utili thorization No.: Existing Service: 2�� Amps 7'�®/L7'oIts Overhead Underground 0 No.of Meters: New Service: Amps / Volts Overhead 0 Underground❑ No.of Meters: .. Des ription f Proposed lectrical s latio AZ- t c� /113k zeA r' Cyr Ice Completion of the folloibing table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type: No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System❑ No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2 0 Level 3 0 Rating: OTHER: Attach additional detail if desired,or as re uirgl y the Inspector of Wires. Estimated Value of Ele cal ork: (When required by municipal policy) Date Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: A-1 0 or C-1 0 LIC.No.: Master/Systems Licensee: LIC.No.: Journeyman Licensee: 44) LIC.No.: /0-7eg.---6 Security System Business requires a 0 iv' ion of Occupational Licensure"S"LIC. S-LIC.No.: Address: LI/ ,1/7/,_' 4 / i' . /. a 7-z Email: f// - N1� 1 0 / #111/40/ , 4077 Telephone No.: _ -) I certify,under the pains , 'pen,It' s of,erjury,that the informati n on this appl'cation ys e and complete. • Licensee: �•� ------ C' / Print Nameo 4 r Cell.No.: INSURANCE COVERAGE: Unless waived by the owner,no permit forth performance of electrical work may issue unless the licensee provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof of same permit issuing office. CHECK ONE: INSURANCE OND❑ OTHER❑ Specify: 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)Owner 0 Owner's agent 0 Owner/Agent: Tel.No.: Signature: Email.: