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Home My WebLink AboutBLDE-22-003142 Commonwealth of Official Use Only nMassachusetts Permit No. BLDE-22-003142 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:12/2/2021 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) 18 NORTH SANDYSIDE LN Owner or Tenant LINK JUDITH A Telephone No. Owner's Address 60 WITHERELL DR, SUDBURY, MA 01776 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 patio next to pool, sub panel, &conduits in ground. 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 g boved. ❑ gr nd. ❑ No.of Emergency Lighting rn 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 Ton 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of No.of Devices or Equivalent Noaters ater KW No.of No.of Ballasts Data Wiring: 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: Licensee: Timothy Robery Signature LIC.NO.: 57427 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 1 Carol Road,Buzzards Bay MA 02532 Alt.Tel.No.: 5083640419 *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 iv i/ e ill 44 / WWA- r Na ry�y` t aa!! y�j // g DEC 0 1 2OLtonmonweaGtho ///addacLttd Official "" Use only 4..�`•as. i 2epartnunt oil. ire serviced Permit No. 2— l v ",, , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK It 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) City or Town of: YARMOUTH Tu Date: j— ; �� .- ires: By this application the undersigned givYAnotice RM his OUTHintention to perform the ele trical wTo the Ins et& �kdescribed below. Location(Street&Number) t,_ Owner or Tenant '- " �� Owner's Address Telephone No. ( e- e / 4 Is this permit In conjunction with a building permit? Yes Purpose of Building NO (Check Appropriate Box) Utility Authorization No. Existing Service_,, Amps _ /TJ_Volts Overhead ElUndgrd 112/ No.of Meters 4 New Service Amps / Volts Overhead El Number of Feeders and Ampacity Undgrd El No.of Meters Location and Nature of Proposed Electrical Work: C: Com le on o the of owin table m be waived b the Ins ector o Wires. t,1,? No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.° ota No.of Luminaire Outlets Transformers KVA f`", No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ore ❑ n_ o.o mergency g n rnd, nd. Batte Units g No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o etecdon an `'' No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No,of Alerting Devices No.of Waste Disposers eat ump um er ons Totals: Det coon/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ un ctpa No.of Dryers Heating Appliances Connection ❑ � o.o a er KW ecun ty ystems: o.o No.of Devices or E uivalent Heaters °.° Data Wiring: Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommuntca ors irmg: OTHER; No.of Devices or E uivalent ' Attach additional detail if desired,or as required by the Inspector of bfn•s.. d� Estimated Value of El ctri al Work: Work to Start: r . ' - =-- r' (When required by municipal policy.) ,fS7l")6, - Inspections to be requested in accordance with MEC Rule 10,and upon completion. 4- ./)/~ INSURANCE C E GE: 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 cover s to force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ �, BOND ❑ OTHER ❑ (Specify:) I certify, under the ns and penalties f perjury,that the information on this application is true and complete FIRM NAME; Licensee: _ LIC.NO.: � _ (If applicable,enter"ex nrpt"in the lice e number ire.) Signature LIC.NO.: Address: Bus.Tel.No.s C oyeC, *Per M.G.L.c. 14 s.57-61,security work requires Department of Pub c Safety"S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insuranc coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agenty Signat 0owner � owner's a.ent. Telephone No. /,— , / ,t'ERMIT FEE: $