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Home My WebLink AboutBLDE-23-002194 .fir= Commonwealth of Official Use Only •. Permit No. BLDE-23-002194 ��,�� Massachusetts 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:10/24/2022 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) 213 OLD MAIN ST Owner or Tenant SULLIVAN DONALD J Telephone No. Owner's Address SULLIVAN JUDITH M, 213 OLD MAIN ST, SOUTH YARMOUTH, MA 02664-4529 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: New bedroom&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 0 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 Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: ROBERT M SCENA Licensee: Robert M Scena Signature LIC.NO.: 21570 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 Marilyn Rd,PO BOX 43,Buzzards Bay MA 025323733 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 0. ls( /2 :. t: : t 'o,-u„ `t-(74 t5 �%.. l y L 1 lr"1 1 � I OCT 2 122 I - ,x .e BUILDING D � K; /t/ y�j By C/ ommonwsa&o`rr/adeachudalle Official Use Onl14 ytil _s y r�,.� �aP `�• S' Permit No. �'� V a+t►nsnl o f a+x srvicsd L . `' BOARD OF FIRE PREVENTION REGULATIONS Occupancy0 and Fee Checked -------.___._ )\\. �'' Rev. 1/07) leave blank al I APPLICATION FOR PERMIT TO PERFORM EL �+ kN t i All work to be performed in accordauce with the Massachusetts Ele ECTRICAL WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ate:]CO_ ___ 1'527 CMR 2.00 .` ! City or Town of: Date: �Z YARMOUTH To the Inspector of Wires: 1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) U� Owner or Tenant C' ' ,-7C;, Owner's Address Telephone No. 1.. Is this permit in conjunction with a building perm t' Yes Purpose of Building �C No 0 (Check Appropriate Box) Existing Service Utility Authorization No. �0 'N is Amps / Volts ndrd 0 No.of Meters Overhead❑ Undgrd Number of Feeders and Ampacity rvice Amps / g Volts Overhead Undgrd0 ❑ No.of Meters _ Location and Nature of Proposed Electrical Work: sr Recessed Com,letion o the ollowin:table m be waived b the Ins,ector o Wires. n i sed Luminaires No.of CeiL_Sus p (Paddle)Fans '°•o ota ll�; No.of '1 No.of Luminaire Outlets Transformers KVA No,of Hot Tubs Generators KVA ,� No.of Luminaires • 't Swimming Pool ,rode ❑ n- 'o.o Units c No.of Receptacle Outlets nd• ❑ Bette Units y g ng •:1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o i 1 No.of Ranges etec on an No.of Air Cond. ota Tnitiatin Devices No.of Waste Disposers 'eat 'um Tons No.of Alerting Devices p 'umber Totals: - _._....... on o.o e onta ne, • �� No.of Dishwashers Detection/Alertin, Devices Space/Area Heating KW Local •un a tl No.of Dryers Connection ❑ Omer Heating Appliances `o.o "a er KW ecu ty ystems: Beaten Ballasts , `o.o .o o No.of Devices or E i uivalent No.Hydromaaaage Bathtubs Si:ns Data Wiring: No.of Motors No.of Devices or E.uivalent OTHER: Total HP a ecommun ea i ons " r ,g; No.of Devices or E.uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as policy.) Work to Start: o Electrical 2 (When required byrequired by the Inspector of Wires. Work Z Inspections to be requested in accordance with MEC Rule 10, INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work the'licensee provides proof of liability insurance including"completed operation"coverage or its and upon completion. undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing may issue unless CHECK ONE: INSURANCEsubstantial equivalent. The I certljy,under the pa sand BOND 0 OTHER 0 (Speer office. FIRM N penalties u erJury,that the t+joG�o��n this application is true and complete. Licensee: ll V '/fapplicable. er" r7 Signature ' ''z"`giC.NO.: y'�d Address: exem t"in the license number �. ., l — ----� LTC.NO.:I-- r OWNS*Per M.G.L.c. 147,s.57-61,security work requires C f'�6..-_U�..-7 e Bus.Tel.No. 'OWNER'S INSURANCE WqI 9 i es Department of Public SafetyLicense: •Tel.No.: •-{r �� by law. g gn E'ER: tam aware that the Licensee does not have the liability insurance coverage y my si n AI below,I L.ic.No. SignatOwneure gent y waive this requirement. I am the(check one owner > Signature $ normally ae Telephone No. owner's a;ent. PERMIT FEE:$