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Home My WebLink AboutBLDE-23-001986 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-001986 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:10/13/2022 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) 23 GLENWOOD ST Owner or Tenant Beth Doran Telephone No. Owner's Address C/O RACHEL-GLENWOOD, 4 MALFA RD, WEST YARMOUTH, MA 02673 Is this permit in conjunction with a buildingpermit? t ; Yes 0 No 0 (Check Appropriate Box) n Purpose of Building Utility Authorization No. 10759165 ,q ,7/('�JExisting Service Am s (7)"�P Volts Overhead ❑ Undgrd ❑ No.of MetersCitc.i:„ New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Trench Inspection, New Service 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 Initiatine 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 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devics 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:) SV —Z8Q— 5 (l�I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JONATHAN R HALL Licensee: Jonathan R Hall Signature LIl. NO.: 11925 (If applicable,enter"exempt"in the license number line.) Address:263 CAMMETT RD, MARSTONS MILLS MA 02648 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. I PERMIT FEE: $75.00 li ( Jan i fqf�?/ z Q7(01,4 -- 74 Etaget vee-j fig _ �o mo weaCth o//r/aoaachueetta Official Use Only :roam; t T 1- 2 2022 c �, Permit — 3 epart�nent o� ire �erviceb No. — Si�/� g 410 ' — :INc OARD OF EIFRE PREVENTION REGULATIONS Occupancy and Fee Checked _ [Rev. 1/07] (leave blank) 15PLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code(M WORK ORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ��,�,�,_ j) City or Town of: �;�, --� To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electric work scribed below. Location(Street& Number) Owner or Tenant 3c' ` Telephone No. 'l Owner's Address (A, ? 11 S, ot Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building (Check Appropriate Box) Utility Authorization No. (;) e'j (p Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service +� Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd✓ No. of Meters Location and Nature of Proposed Electrical Work: Completion o the ollowin• table ma be waived b the Inspector o Wires. No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. of Transformers Total No.of Luminaire Outlets No. of Hot Tubs KVA Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ `o. o mergency ig mg No.of Receptacle Outlets _rnd. rnd. Batter Units No. of Oil Burners FIRE ALARMS No.of Zones No. of Switches No. of Gas Burners No.of Detection and No. of Ranges Initiatin. Devices No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW Totals: No. of Self-Contained No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local❑ Municipal Connection ❑ Other No. of DryersHeating Appliances KW Security Systems:* No.of Devices or Ei uivalent No.of Water No. of Heaters KW No. of Data Wiring: Sig ns Ballasts No.of Devices or E i uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lect ical Work: A=. .L, (When required by municipal policy.) Work to Start: 10 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV RA E: 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 v/ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 75',,., , • Licensee: ThL LIC. NO.: "exempt"l,j 4 Signature C (If applicable, enter exempt an the license number line. LIC. NO.: 13 Address: ,ti ill Bus. Tel. No.: *Per M.G.L. c. 147,s. 57-61, security work requires Depattulent of Public Safety"S"License: Lic.No. Alt. Tel.No.: .IMAMS 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/Agent Signature E]owner's a:ent. Telephone No. PERMIT FEE: $