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Home My WebLink AboutBLDE-22-007442 oF...te , Commonwealth of Official Use Only i`n Massachusetts Permit No. BLDE-22-007442 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:6/28/2022 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) 15 JONQUIL RD Owner or Tenant PETERSON JAMES M CO-TRS Telephone Owner's Address PETERSON ELLEN A CO-TRS, 15 JONQUIL RD, YARMOUTH PORT, MA 02675 No. Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 Number of Feeders and Ampacity gNo.of Meters Location and Nature of Proposed Electrical Work: Split A/C system 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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 andpenalties o fperjury,that the information on this application is true and complete. FIRM NAME: Charles K Swanson Licensee: Charles K Swanson Signature LIC.NO.: 12895 (If applicable,enter"exempt"in the license number line.) Address: 718 CEDAR ST, W BARNSTABLE MA 026681300 Bus.Tel.No.: *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE: $50.00 I Commonwealth o/Maedachulettd Official Use Only mi- Th c7 Permit No. eZZ- L epartment o/..yire Serviced ettiffi BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked `" [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 N (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (0122/22 • e Inspector of Wires: 9 City or Town of: Y oC By this application the undersigned givesa none of his or her intention to perforh To m the electrical work described below. 0_1 Location (Street&Number) 15 ,kAct,ui\ edt `(0.tM0U 1n fnct- a Owner or Tenant 3Gn o� ces peceas Telephone No. 508-2.-N-553% a Owner's Address 15 Ipt\tv,i\ Rd m l) `(o nowt\n2ot k' L1i Is this permit in conjunction with a building permit? Yes ❑ No d Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service WO Amps / Volts Overhead 171' I Undgrd❑ No.of Meters t New Service Amps / Volts Overhead �-7 I I Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: w;r,n9 mint sews- system 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 INo.of Zones No.of Switches No.of Gas Burners INo.of Detection and No.of Ranges Total Initiating Devices No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number [Tons I KW 'No.of Self-Contained Totals: ( Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW 'Local❑ Municipal Connection Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Signs Ballasts Data Wiring: No.Hydromassa a Bathtubs No.of Devices or Equivalentg No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: # ytXJ Work to Start: (When required by municipal policy.) (0/22422 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 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 L BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Clnot .Swans q • e . i Cbo , Licensee:CM. ...5 u3oa\son LIC.NO.: i28g5 A Signature -w LIC.NO.: (If applicable,enter exempt m the license number line) Address: '2 Y0.renoLt.�� la uyr d►S Ms UK" Bus. el.No.:_ 5og-T�s_�08� Alt *Per M.G.L. c. 147,s S/ 61,security work requires Department of Public Safety"S"License: Lic.No. .Tel.No.: 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 Owner/Agent y Signature ❑owner's a:ent. Telephone No. PERMIT FEE:$