The URL can be used to link to this page

Home My WebLink AboutBLDE-23-005761 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-005761 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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) 66 WEST GREAT WESTERN R Owner or Tenant Starbuck Construction Telephone No. Owner's Address 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: In ground Pool 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 Heat Pump Number Tons , KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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: EAV SOLUTIONS Licensee: JEFFREY S DEROUEN Signature LIC.NO.: 22206 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 110 Hedges Pond Road, Plymouth MA 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: $65.00 l✓ . 'A-T.Q � 1 NO iF.r.r3tzAb 60E6-24-) c(( IBA& (Lc orvollOz 57123 1 � �� f Print Form i, arnar•„^revea h alp. aJdac wseftiI r Official Use Only rA APR _ t e1.Jepartmeat of ire Servicee gwE"2 3"-�S`�!'Ol Permit No. ` -� ARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked BUILDING J: ,:s LENT By [Rev. l/07] (leave blank) ATiON 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 r vFURMATION" Date:4112/23 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 d cribed below. Location(Street&Number)66 West Great Western Road / 0 , 2 • Owner or Tenant Starbuck Construction Services Telephone No. 508 827-7134 Owner's Address 176 Sudbury Lane Hyannis, MA Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building Pool (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead C Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In-ground pool Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above I-, In- n No.of Emergency Lighting No_ofLnminaires Swimming Pont kits. `g'rttd. Batten, Uiiiis No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o.of Switches No.of(;as Burners" tection.ate Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons (KW 'No.of Self-Contained Totals:I i Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local corrilccfit�ii Other No.of Dryers Heating Appliances KW Security Systems:* N .of Water of No.of Devices or Equivalent Heaters KW No. No,of Data Wiring: Signs Ballasts No.of Devices or Ecuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: I 'OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires.I 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 l+i'1NCE 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 L✓i BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FiRM NAME: EAV Solutions. LLC Licensee: Jeffrey Derouen LiC.NO.:860 Al Signature LIC.NO.:22206-A (Ifapphcable,enter "exempt"in the license number line.) Address: 110 Hedges Pona Roaa Cedarville,MA 02360 Bus.Tel.No.:(508)245-7155 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt Lic TNo. 1781 l 589-5692 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:$65.00 n