The URL can be used to link to this page

Home My WebLink AboutBLDE-23-002701 _ Commonwealth of Official Use Only 11. ..,' Massachusetts Permit No. BLDE-23-002701 .` 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:1 1/15/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 81 BRAY FARM RD NORTH Owner or Tenant COHEN NEIL S Telephone No. Owner's Address FULWIDER-COHEN LESLIE, 81 BRAY FARM RD NORTH,YARMOUTH PORT, MA 02675 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: Install generator 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 1 KVA 20 No.of Luminaires Swimming Pool Above ❑ In- I: No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges 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 ❑ Conne Municipalion ❑ Other: Security Systems:* No.of Dryers Heating Appliances KWNo.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 pennit 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: BRYANT K DUNDON LIC.NO.: 53109 Licensee: Bryant K Dundon Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line) Alt.Tel.N . Address:67 TAURUS DR, MASHPEE MA 026493458 *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 0owner's agent. signature below,I hereby waive this requirement.I am the(check one) 0 ownerI Owner/Agent I PERMIT FEE: $75.00 Signature Telephone No. I�-t-1Vai 4 2'o v0urr `*z.7. ( d -u 7(t cc 10a w 11 . :n4-o61 G... s L ) n" ) ►� RECEIVED o aaGth ol///aatachuniItd Official Use Only . : w;tNOV 15 202 - s z70 ( �..�tif;t c7 (� Permit No, -- t- .. -at•w ..__. sp- Inlaid o/. ira Jorvrc�d , 1'LDI Occupancy and Fee Checked `' ARD O RE REVELATION 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: /2 — /5— City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives noti a of his or her intention to pe orm he electrical work described below. Location(Street&Number) rj /7��j�to i /�i� ,/t/e,,-f-� Owner or Tenant ,�5A�. / 6-�� Telephone No. Owner's Address �f 8, , �� p� Is this permit in conjunctio ith a buitdi g permit? Yes /❑ No ❑ (Check Appropriate Box) Purpose of Building A,j�� /� Utility Authorization No. Existing Service /o a Amps f ea /21 p Volts Overhead Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity . fie, / /A- Location and Nature of Proposed Electrical Work: Completion of the followinztable meg be waived by the Inspector of Wires. q- No.of Recessed Luminaires No.of Ceil: Fans Snsp.(Paddle) No.of Total Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators / KVA a...r ‘ i' No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting rnd. 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 s; i Initiating Devices 1-' No.of Ranges No.of Air Cond. Tongs No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/AlertinDevices No.of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Data Wiring: Heaters 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: /0 G< (When required by municipal policy.) Work to Start: 7_ 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 ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify,under the pas and nalties ofury,that the information on this application is true and complete. FIRM NAME• t,.,..t f �/ / 7 <//.�..-�i LIC.NO.: ,S)/c)9 !� Licensee: 6,,,,,_ „2 ,,,, Signature , LIC.NO.: (If applicable,en 'exempt"in the li nse number line.) `� � Bus.Tel.No.: 77yc/ Address: �y ��,r� i 7e_-_ ` /OS- C., Gc,.� Alt.Tel.No.: *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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$