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Home My WebLink AboutBLDE-23-004491 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004491 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:2/14/2023 City or Town of: YARMOUTH To the Inspector of Wires:ZL U3 3 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. l Cry Location(Street&Number) 482 WEST YARMOUTH RD1112gi(`eif Owner or Tenant BARLOW DENISE M Telephone No. Owner's Address 50 HOUDE ST, MARLBOROUGH, MA 01752 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: Split A/C&add sub panel. 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 ❑ 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: Dana K Otis Licensee: Dana K Otis Signature LIC.NO.: 27163 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19C GIDDIAH HILL RD, ORLEANS MA 026534013 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 4(( e(2,3 4-4-41) /-2,q (qx( r ECElvEDI .,. -s. , i 3 2123 C montvaa[th of ii/aeeachadelte Official Use Only r.,, ., 1 T 1t;' ` Permit No. s2�7 ,,„ •x,u, apartment o�-}ira Service,' =, 1�s. .r DEPARTMENT •.ARD...QF E PREVENTION REGULATIONS Occupancy and Fee Checked t__° . :,, [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: , "f -•' 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 he electrical work described below. Location(Street&Nu ber), .Cig , X-9f lc4j /, Owner or Tenant 'ten t S G. B�r9-✓t rat j Telephone No.7.7Ef y�q•-y',326,3 Owner's Address S•91. K= Is this permit in conjunction with a building petit? Yes ❑ No�, (Check Appropriate Box) c Purpose of Building C,t� ?�� me_ Utility Authorization No. Existing Service 9 Amps //O /..??0 Volts Overhead 2t Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 0 '9[ Location and Nature of proposed El trical Work: 4et 4/c c- 4 un tie( S4 Mil c(-- 1 P Completion of the following.table m be waived by the Inspector of Wires. 'VA Q: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.off Total Transformers KVA '-Tt No.of Luminaire Outlets No.of Hot Tubs Generators KVA A. 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 Nu.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 No.of Dishwashers Space/Area Heating KW Local 0 Municipal n 0 Other ~' No.of Dryers Heating Appliances Kit, Security Systems:* o No.of Water No.of Devices or Equivalent Heaters KW No.of 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: r Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �l� (When required by municipal policy.) Work to Start: 7 p� /0'"%�J 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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of per ,th t the information on this application is true and complete. FIRM NAME: cliA e r LIC.NO.:reA 7/k3 Licensee: ISignature ' LIC.NO.: (if applicable,eye'e em�,p�f. 'the licensg ry m er l' e. n /y/ � 0/6 0 Address: /7'c t�'�s�/'.o/N �•i t 1 /-� rift (�l3 9 Ro (J.� ,5",3 Bus.Tel.No.;�%�1 -' .. *Per M.G.L.c. 147,s.57-61,securitywork re u' �' / Alt.Tel.No.: qDepartment of Public Safety"Si'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)0 owner 0 owner's agent.Owner/AgentI Signature Telephone No, l PERMIT FEE:$