HomeMy WebLinkAboutBLDE-23-004611 . OF- 4;1/ etweenvewedei QQderad Official Use Only
`� Permit No. BLDE-23-004611
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:2/21/2023
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) 60 BAYBERRY RD
Owner or Tenant Steve Hetzel Telephone No.5082595252
Owner's Address 60 Bayberry Road, West Yarmouth, MA 02673
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. (2O it1"'7 Z
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of eters
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters CIC t..-1 eu.,3
Number of Feeders and Ampacity p ty g VI-YLS
Location and Nature of Proposed Electrical Work: new louse&grounding. ik2c;(1.3
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
r.„....„fnv,.,n..o YV A
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
r...c
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
r„t..to• 11.1-.n+4..n/A1n.-+;.,,.no.r;,.oC
No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other:
No.of Dryers Heating Appliances KW Security Systems:*
NT. .,f ino.r;..oc.,.I'.,.,;.r.,lo..+
No.of Water KW No.of No.of Ballasts Data Wiring:
j7oo4...r. Q;..... N. ..f llo.,;,...o.,,.R....;.,,.l..o+
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
X. ,.f rlo.r;nnc rra.F,...;,r..lont
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: ALAN R O'REILLY
Licensee: Alan R O'Reilly Signature LIC.NO.: 51570
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address 12 LENTELL ST, SANDWICH MA 025632116 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
Signaturejj Telephone No. PERMIT FEE: $230.00
R. -ate 6f _,,,,j4 z./Z-3 e4'1f23 �et�.
c,w:4 t_ 014- 1//Z 3/2,,�
k 2-5l- (A 6 t(Z.G)
RECEIVED
c7aq_a 33
. F Q23 ommonwealth of Massachusetts Official Use Onl
Permit No.: 6c, --2.3—(i[p f t
io! Department o f Fire Services Occupancy and Fee Checked:
BU1L( g— 1 TiVIEiVT p / P Y
BY:_ ►; ;4--BOAR 4I OF FIRE PREVENTION REGULATIONS [Rev. 1/2023]
''• 4 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CM 12.00
City or Town of: YARMOUTH Date: .�1'7 ,;13
To the Inspector of Wires:By this application,the undersigned gives notices of his.or her intention to perform the electrical wor described below.
Location(Street&Number): 60 8 b ex-r .l. .c 0a Unit No.: —
Owner or Tenant: -� c�e-f -t Email: 3 1— t-c-Z Hok,r,,xo;; t , (.1,4‘1
Owner's Address: 5Ry•A.e- c�S o;b vst.- Phone No.: 5 c;g' rQ.S
Is this permit in conjunction with a buildingpermit?(Check appropriate Yes o Permit No.: 9 - �� �a
box) ❑ oZ3 �' U 03 00,3
Purpose of Building: 't,.r��‘,vv� Utility Au horization No.: f a G `
Existing Service: Amps / Volts OverheadUnderground �� '�
El
g El No. of Meters:
New Service: ad 0 Amps \[O/ V Volts Overhead❑ Underground No.of Meters: (
. Description of Proposed Electrical Installation: \&)t tom, Y\e..tr, \r\..o �S S
t
Completion of the followin table may be waived by the Inspector of Wires.
No.of Receptable Outlets: No.of Switches: Generator KW Ratin g: Type: ',
No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating:
No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA:
Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW:
No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices:
Swimming Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices:
No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices:
No.Air Conditioners: Total Tons: Telecom System❑ No.of Outlets:
No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices:
Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment:
No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 0 Level 2❑ Level 3 0 Rating:
OTHER:
Attach additional detail if desired,or as required bb'the Inspector of Wires.
Estimated Value of Electrical W rk: . (3 (When required by municipal policy)
Date Work to Start: 4 1'7 '7) Inspections to be requested in accordance with MEC Rule 10,and upon completion.
FIRM NAME: a It [-e,G'IN--;c,t‘u
A-1 ❑ or C-1 ❑LIC.No.:
Master/Systems Licensee: LIC.No.:
Journeyman Licensee: ..ct✓i DC
ge)it LIC.No.: E.-5 15 1-
Security System Business requires a Division of Occupational Licens re"S"LIC. S-LIC.No.:
Address: as I- tv e.._1 �'
l {-" t; 5 e- wl i C\-t �4 (:),a,,(:),a,, c.3
Email: t i��A. .e._l e-c,_..-•i C-. e____ wlp.A [ \AA Telephone No.: c 6-O g) g k C C 1..7
I certify,under the pains tes er iir that 1p ! y, the tr�for 'Mion on this application is true and complete.
Licensee: Print Name: . u�t !/ c
INSURANCE COVERAGE: Un ss waived by the owner,no permit for theperformance work
No.:s ue unless the licensee
(�'f�� Z��
provides proof of liability includin completed operation"coverage or its substantial equivalent.The tundersigned certifies that such coverage
is in force and has exhibited pro of same to the permit issuing office.
CHECK ONE: INSURA E❑ BOND❑ OTHER 0 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 El Owner's agent❑Owner/Agent:
Tel.No.:
Signature:
Email.:
a36