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Home My WebLink AboutBLDE-23-003788 1sVtip Commonwealth of Official Use Only E. 147 Massachusetts Permit No. BLDE-23-003788 ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:1/12/2023 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) 938 ROUTE 6A 0 �� E L AN OP Owner or Tenant I Telephone No. Owner's Address 938 MAIN ST,YARMOUTH PORT, MA 02675-2172 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: Wiring for office area of building. 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. grnd. 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 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: ROBERT F THIBEAULT Licensee: Robert F Thibeault Signature LIC.NO.: 22475 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:36 GOVENOR BRADFORD RD, BREWSTER MA 026312806 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:$100.00 ,��C+� t� .3/21 I c RECEIVE ® em.c.(I. ) asc,crctn ck___ • IAN 112023 1/0 la CCAI , BUILDING DEPARTM Commonueaa[th Maeaachuesiie Official Use Only ..,., BY — q 1�-tea �c77 PermitNd -2-3 3'� 1�n k. spartmenf of irs.3srvicse ` . 7, Occupancy and Fee Checked s., BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: " !/'z- 3 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} —, jc �� r,. Owner or Tenant 0 C -I(-- 0 2 ;1 y-'-, 6 _C Telephone No. Owner's Address s.'47 Is this permit in conjunction with a building permit? Yes Q No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service '/ ' Amps /2 0 /2' a Volts Overhead❑ Undgrd _, g ❑� No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity 'i - /b C, Location and Nature of Proposed Electrical Work: (,'(, c2 ((2 •T .i7 - . tf k Completion of the following table may be waived by the Inspector of Wires. U No.of Recessed Luminaires No.of Cell.-Susp. No.of Total r;0 p (Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,t' No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grnd. grnd. ❑ Battery Units `.1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones '` No.of Switches No.of Gas Burners No.of Detection and ~ Initiating Devices 11,1 No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 un Connecticipaott 0 °ther No.of Dryers Heating Appliances KW Security stems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts 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: 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 Q BOND 0 OTHER 0 (Specify:) C Ciu//OR.C "' W Zz/�3 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: 625 7�t '2 r i i i Signature-__ --/ LIC.NO.:L%22 ?•Y-- (If applicable rater"exempt"in the license number line.) Address: - 6w ele,,q-6 -f , 3 zz '2141 . / Bus.Tel.No.;_73? 173� Tel.No.: *Per M.G.L.c. 147,s.57-61,security work quires Department of Public Safety"S"License: Alt.Lie,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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$