The URL can be used to link to this page

Home My WebLink AboutBLDE-23-002750 Commonwealth of Official Use Only t Massachusetts Permit No. BLDE-23-002750 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:11/17/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform th ere trii all work scribed below. Location(Street&Number) 44 &48 ROUTE 28 j fi Li .c , Owner or Tenant ,t ' -- Telephone No. Owner's Address Vn,(O JQ61m-'IUT.Cl4 N gal( FA 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: Remodel&reconfigure lighting Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 24 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 12 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine 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:) a/3- q5. - I (i q I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DAVID PICARD Licensee: David Picard Signature LIC.NO.: 13902 (If applicable,enter"exempt"in the license number line.) Address: 19 ELLIOTT RD, CENTERVILLE MA 026323643 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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 ❑ owner's agent. Owner/Agent Signature Telephone No. � i2� 'PERMIT FEE: $260.00 I r 2 ( l I v % (Mat' ir. ) / � � R E C E I �/ E � -emit ltisr,�uncc_ `. . , 4 Commonwea4th o/,a4eachuostt6 Official Use Only NU c� �7 Pecuiit No. 23- -7 d 2)spartmsnt o/. ire Seruicss t--- �� °:1 * ENT T BUILDINt: Occupancy and Fee Checked By:_ g.. ar ---BO'RD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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: \t\-1,\2-7— City or Town of: O ••,k ,M,0--} To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. CJJ Location (Street&Number) �N - 2c ��o ,r M( J\ ®a(o- 3 .-. og Owner or Tenant MO„,k("-k tr5c, Telephone No. Owner's Address n t c: ouy '�t- i, )-&-e,4'e t;,Clc ' a(Vth ftc/\ 1,.A4c c., s-37 r.--- Is this permit in conjunction with a building permit? Yes LE No E (Check Appropriate Box) Purpose of Building 10. GI) �'‘+(\oc - Cakail Utility Authorization No. Cr C - Existing Service San Amps ,I2o/ Z-4(7 Volts Overhead 4 Undgrd E No.of Meters .S ` (....4 New Service Amps / Volts Overhead`� p E Undgrd ❑ No,of Meters m C? Number of Feeders and Ampacity C Location and Nature of Proposed Electrical Work: Q 0,COn--Bock_f \sC�-�\(\5 - ; M OLt2 -mac. , tomv nS Yk C cs. +ti Q..Q t\, co "As#"`ll 1 uS t°'''', tS �R- vy� i ComplelMn of the followingtable may be waived by the Inpector of�Wires. Total 1 No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tranf KVAC�� Transformers KVA 2 No.of Luminaire Outlets No.of Hot Tubs Generators KVA rn e No.of Luminaires 1 ,- Swimming Pool Above ❑ In- ❑ No.of Emergency Ergghhng grnd. Battery Units ,r- B No.of Receptacle Outlets (6_ No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na.of Detection and 1O Total 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/Alerting Devices n i. 4 No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent s No.of Water No.of No.of Data Wiring: Heaters KW g No.of Devices or Equivalent Signs Ballasts 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: e,0 C r..a (When required by municipal policy.) Work to Start: t l\e 12Z 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 (yl BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 1. a.)3o c ?.co..,r,N- 0\e.k-C'\t''2a.,\ LIC.NO.: \YAM-o\" Licensee:' C()..)i 2\C ,a, Signature L, s LIC.NO.: (If applicable,enter "exempt"in the license number line.) 1 T—�� Bus.Tel No.: 9 I3'C q�.T�j Address: VIPs FA\1� D '(.�\ 'i I1Ql .1...A O# Alt. C'l� *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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. ` PERMIT FEE:$ .(,O 1