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Home My WebLink AboutBLDE-23-005292 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-005292 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:3/28/2023 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) 19 WILDFLOWER VILLAGE Owner or Tenant GLENN HANSEN Telephone No. Owner's Address 19 WILDFLOWER,YARMOUTH PORT, MA 02675-1474 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 basement&bathroom. 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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: $75.00 Zx.44 (-2(./ta' E C �` E D Commonwealth of Massachusetts ffic;al Use only�__- r+ Permit No.: 23 -5 2-7 Zi �� / I Department of Fire Services Occupancy and Fee Checked: 1 MA°; _: 44 BOA D OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] 3UILDING U0rtiuTrElk PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK By --- a performed in accordance with the City or Town of: YARMOUTH Massachusetts Electrical Code(MEC), 527 CMR 12.00 Date: 3—)'7- 3 To the Inspector of Wires:By this application,the undersigned gives notices of his or her intention to perform the electrical work described below. Location(Street&Number): 19 (, \G,C'0(.)t,_ L«t\ Owner or Tenant: (;, Unit No.: �+-nn l�ran 5 4.0 Email: Owner's Address: j 1 \), k C\0 cJ t c L G.c-,Z Phone No.: 6 5-0 9 8?j 5-Pr7 5-- Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No El Permit No.: Purpose of Building: D W e \\'k Existing Service: Utility Authorization No.: A ps / Volts Overhead El Underground El No. of Meters: New Service: Amps / Volts Overhead❑ Underground g El No.of Meters: Description of Proposed Electrical Installation: RI) ,c, U.)t r.t C e.n.A to Loc ( h LJ c.A"h Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: No.Luminaires: No.of Recessed Luminaires: Generator KW Rating: Type:. No.Wind Generators: Wind KW Rating: No.Appliances: KW: No. Water Heaters: KW: No.Transformers: Space Heating KW: HeatingEquipment KW: Total KVA: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Grnd.❑ Above-Grnd.❑ Hot-Tub No.Oil Burners: ElNo.of Self-Contained Detection/Alerting Devices: No.Gas Burners: Video System y 0 No.of Devices: No.Air Conditioners: Total Tons: Telecom System a Rating: ❑ No.of Outlets:vice No.Energy Storage Systems: KWH Storage Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Ratin No.of Modules: Roof-Mount El Ground-Mountg. No.of Electric Vehicle Supply Equipment: OTHER: 0 Level I ElLevel 2 ElLevel 3❑ Rating: ............... Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: !j 0 0 Date Work to Start: 3� (When required by municipal policy) " 3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: O>?,3t 1-\ C c L (\ Master/Systems Licensee: !�-1 ❑or C-1 ID LIC.No.: LIC. No.: Journeyman Licensee: S\-Ny'�. 4-, t . LIC.No.: Ij 3 4`1() — Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: `6' C f,� ��.c� 0 ;�` R c ...- CSC C'k L T Y\ I kY� Email: t lu�� LPL � QCA6 � a(\� U(� q ``�� `(mac: I �c(� Telephone No.: �Z TI —1 I 1"i 0 4 b I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. Licensee: -56 S� • \ e..3c;\e Print Name: i h ;�� INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee n provides proof of liability 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[O BOND❑ OTHER El Specify: 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: Tel.No.: Signature: Email.: