BLDE-23-005777 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-005777
`+TMo 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:4/19/2023
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 bel w y1 p
Location(Street&Number) 25 COVE RD , 1 4,60
Owner or Tenant JOHNSON HELEN H (EST OF) lephone No.
Owner's Address C/O JOHNSON RONNA,43 MARION RD,WATERTOWN, MA 02472
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 ❑ 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: Remodel (Water damage)
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 3 No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 10 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 6 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
p Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal
Connection
0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Euuivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Euuivalent
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: STANLEY D ANDREWS
Licensee: Stanley D Andrews Signature LIC.NO.: 15248
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:201 HEAD OF THE BAY RD, BUZZARDS BAY MA 025325640 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: $75.00
t-‘.-6.0441 q(0.1"7
7 C<-t;W - (Ajar) u / 3e - fr/itt)
Vre:---( ),, 0 7(147 rani
RECEIVED IocLC 86 , 9'{(03
Rectcly Ai-
18 4. 4. Commonwealth el Maeeaclute.lfs Official Use Only
` �_�� ? i• t �• n# Permit No. 3
B 4 a' PARTMENT `7 `�' K� �/
By
. r� = FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
-'0' _ [Rev. 1/07)
.1 (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
j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /? ,)
City or Town of: t -✓tvtv t ,
�1� To the Inspector of Wires:
i
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
1Location(Street&Number) ,S Co
1 L/ I-cX
Owner or Tenant t✓ tri_^-& '\ , it A- :rC:^- Telephone No. 44�
IC Owner's Address , t 4
— Is this permit in co notion with a building permit? Yes 21 No
C (Check Appropriate Box)
Purpose of Building �-/ I 'v .c} Utility Authorization No.
Existing ServiceQ J Amps I)c /. ye) Volts Overhead Undgrd C No.of Meters
N New Service Amps / Volts Overhead
❑ Undgrd g ❑ No.of Meters
Number of Feeders and Ampacity
-42 Location and Nature of Proposed Electrical Work: rnu4ia c,„,,v, ,t..vt ,/ ,1,4v,„Il.7 i h.k e'r
kit Completion of the followin table may be waived by the 1�e ctor of
Wires.
No.kb of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of Total
„ Transformers KVA
qNo.of Luminaire Outlets ,3 No.of Hot Tubs Generators KVA
4° No.of Luminaires -3 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grad. and. Battery Units
No.of Receptacle Outlets 6/ 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. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/AlertingDevices
No.of Dishwashers Space/Area Heating KW Local Municipal other
❑ Connection ❑
No.of Dryers i Heating Appliances KW Security Systems:4
No.of Water No.of Devices or Equivalent
No.of No.of
Heaters Signs' Data Wiring:
Ballasts No.of Devices or Equivalent
Na.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: r/1 7/:0 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE OVERAGE: 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 a BOND 0 OTHER 0 (Specify:)
I certify,under tits ins and penalties of pgrjpry,that the information on this application is true and complete.
FIRM NAME: 11u Z Zf'd-ikS y b-/.fa C 4,o-i
r /, LIC.NO.: f��.yy
Licensee: ` )-��•(,�,,, i4 4, ,�vv,CS Signature vV a....--,
(If applicable,enter; " empt"in t e license number 1' e.) T 6 /'" LIC.NO.:
Address �,'c(,7�r f"k ' Bus.Tel.No.: jGd
2 z- Met C✓.J 5-70 Alt.Tel.No.:730 '•_- :.
*Per M.G.L.c. 147,s.57-61,security workj' `($ 14'7�
requiresDepartment of blic 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 ■ owner ■owner's a'ent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$ ?S--
5 1/