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Home My WebLink AboutBLDE-22-003278 Commonwealth of Official Use Only . ,1 Massachusetts Permit No. BLDE-22-003278 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:12/9/2021 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: In ground pool 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 0 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 Sins 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: $85.00 RECEIVED 14 QQ`` y� DEC 0 8 2021 Commonwealth o{///�eaarhiuesita Official Use Only 'A`>i1;';= c� J I I.DING D E PA R r M NN TT ,+'~; It 2spartimsnt o�}in rwlc — Cl7riA it No. 1Z2�� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked {Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR WORK V (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) � City or Town of: v^ p Date: By this application the undersigned givesr noticer o MbOUTH intention to perform the elTo the ectrical wector ork described below. Location(Street&Number) , Owner or Tenant /V ' Ti. \ � Li�t/'� Telephone No.Owner's Address ti/i - Is this permit in conjunction with a builds g permit? Yes ❑ No ` Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd C No.of Meters \ New Service Amps / Volts Overhead 1 alL• Number of Feeders and Ampacity\X ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: Y 1 . F/ �`/ , /Aw // `` Us"' Corn letion o the ollowin table m be waived b the Ins ector o Wires. No.of Recessed Luminaires No.of Ceil:Sus . o.o p (Paddle)Fans Transformers ota 'Z No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA t' No.of Luminaires Swimming Pool ' 'ove n- 'o.o mergency g n and. nd. ❑ Butte Units g '' Burners No.of Receptacle Outlets No.of Oil ': FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'o.o t etec on an °s' No.of Ranges Initiatin. Devices No.of Air Cond. ota Tons No.of Alerting Devices 'eat 'ump `um l er ons ' ' 'o.o e - onta ne No.of Waste Disposers Totals: Detection/Alertin, Devices cipa No.of Dishwashers Space/Area Heating KW Local❑ C.un Connection No.of Dryers Connection 0 ��' ry Heating Appliances KW ecur ty yystems• "allo.of D `o.o er .o o Devices or E E.uivalent Heaters ' O.° Data Wiring: Si ns Ballasts No.of Dvices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommumca ons r g OTHER: No.of Devices or E uivalent Estimated Value of El'ctri al Wo �� Attach additional detail ifdesired,or as required by the Inspector of Wires. 6 (When required by municipal policy.) Work to Start: AI nspections to be requested in accordance with MEC Rule 10,and upon completion. 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E BOND ❑ OTHER 0 I certify,under the p s and penalties of erjn u ,that the Information on this application is true and complete. FIRM NAME: v L LIC.NO.: Licensee ' r Signature ------- (If applicable,enter"exemp 'in t e license numb line.) LIC.NO.: Address: Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe S"License: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that 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 0 owner • owner's a:ent. Owner/Agent Signature Telephone No. PERMIT FEE:$