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Home My WebLink AboutBLDE-23-000896 Commonwealth of Official Use Only / L, %46, Massachusetts Permit No. BLDE-23-000896 • 15:;§ 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:8/18/2022 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) 5 PAR 3 DR Owner or Tenant BOB LeTOURNEAU Telephone No. Owner's Address 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: Install generator 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 1 KVA 18 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 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: Francis D Jones Licensee: Francis D Jones Signature LIC.NO.: 13534 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:309 Neck Rd, Rochester MA 027701700 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: $80.00 _ l.vra2/nvntvea6t�Z v /Y(a46acl21seett� Official Use Only ccyy,, p Permit No., �J eq(.67_ J aptrnent o .lpe.epulce6 y _, Occupancy and Fee Checked • BOARD OF FIRE PREVENTION REGULATIONS [Rev, l/07) . leave blank • APPLICATION FOR PERMIT TO PERF*RM ELECTRICALWOK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 52 CMR 12, 0 • (PLEASE PRINT IN INK OR TYP 'ALL NPO. TION)_-.// Date; _ C (I 140 -a ?' . • . City or Town ofi S L "1-tom/ " G To the Inspector of Wires, By this application the undersigned gives a ' e of his or h�;'late ' n to perform the electrical work described below: • Location(Street 8i N Der). ' a^ J ri , Owner.or Tenant ,>k.J f C L-r/llr LiTelephone p j.o Telephone No, , Owner's Address _ c, Is this permit in conjunction with a building permit? Yes No — l (Cheep Appropriate Box) Purpose of Building Utility Authorization No, Existing Service Amps / Volts • Overhead : Undgrd�.. g _1 Nof of Meters New Service Amps Volts Overhead Undgrd 2]. No,of Meters Number of Feeders and Ampacity Location and Nature of PI aposed EIectrfcal Work; [ t L _.. l ,`tc� It (�( 't �i Completion of the following table nay be waived by the Ins eater of Wires, No,of Recessed Luminaires No, o No,of Ceil,p5usp,(Paddle)Fans eta Transformers KVA No.of Luminaire Outlets No,of Hot Tubs Generators KVA No,of Luminaires - Swimming Pool A5ove Intl No>of Lmergency LigiftIng grnd, grnd, ® Battery Units _ • _ •No,-of Receptacle Outlets No,of Oil Burners FIRE ALARMS 1-No,of Zones No, of Switches No,of Gas Burners No.of Detection and Initiating Devices No, of Ranges - No,of Air bond, otal No,of Alerting Devices T • Tans No, of Waste Disposers eat�ump 1'iumber Tans 1 0>of Setf"Contained , Totals; ',.,,,,,,,,',,,,�,,,,.•, ,,,,,,.,,,, Detection/AIertfn C J No,of Dishwashers g Devices • t Space/Area Heating KW Local�j Munfcip�I Other Connection No,of Dryers Heating Appliances IOW Security" stems;TM No..of ater • No,of • No.of Devices or Equivalent No,oft Heaters �W Da Wiring; .,�rns Ballasts . No,of Devices ors Eguivalent •No,Plydromassage Bathtubs No, of Motors' Total IMP Te No ofD e nun vi viations Witfngg'; OTHER; No,of Dces or Equivalent f • Attach additional detail{}'•desired,or as required by the Inspector of Wires, Estimated Value of Blectrioal Work; (When required by municipal policy,) Work.to Start; Inspections 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 Iiability 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 ❑ OTHER 0 (Specify;) I certfy,under tlae pains,and penalties of erjury,that tlae Information on this application ' true and complete,FIRM.NAME: i 0/ "C. ,�C d .› '( aAl d LICI.NO.t; Licensee; a }n115 Signature •^‘,.. ,v • p/ • ,.. • {If applicable,enter "exempt"In the license num et.line,' LIC,NO,:Address; �• 'a. S 4 6 Bus,Tel,No,;,: *Per M,G,L,c, 147,s,57-61,security work requires Department o Public Safety"S"License; AIt,Li° No,f OWNER'S INSURANCE WAIVER; I am aware that the Licensee does not have the liability insurance coverage normally. _ reghired.by law.. By my signature below,I hereby waive this requirement, I am the(check one) owner 0 owner's agent. Owner/Agent • Signature Telephone No, PERMIT PEE:,,