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Home My WebLink AboutBLDE-23-002131 _:e Commonwealth of Official Use Only E ,E) Massachusetts Permit No. BLDE-23-002131 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:10/20/2022 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) 63 SMITHS POINT RD Owner or Tenant JIM VALONE Owner's Address 63 SMITHS POINT RD,WEST YARMOUTH, MA 02673 Telephone No. Is this permit in conjunction with a building permit? Yes 0 No 0 /' Purpose of Building (Check Appropriate Box) Utility Authorization No. -., Existing Service Amps Volts Overhead 0 New Service Undgrd 0 No.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A/V&communications(GUEST HOUSE ONLY) 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 Aboved. ❑ In- ❑ No.of Emergency Lighting grn grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 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 ❑ Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Signs Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs 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: (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 I certify,under the pains and penalties operjury,that the information on this application is true and complete. .f FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Address: 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 l 1 "' vcdi i((,f: -- ' I VEC 1 r 1 OCT 2 0 2022 I BUILDING L f r,< .: ;' �orremonwaaGth ol aedachueafte `Y c� Official Use Only '�,'w' -(1a cutmanf i� s' Permit No. _- '_zl 3 P ° rra Serviced BOARD OF FIRE PREVENTION REGULATIONS leave blank t Occupancy and Fee Checked APPLICATION FOR PERMIT TO PERFO Rp[Rev. 1/07) ------_ M All work to be performed in accordance with the Massachusetts Electrical CELECTRICA o WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARMOUTH Date: /a 2 v Lo 22 To the Imp By this application the undersigned gives notice of his or her intentio to perform the electrical work Location(Street&Number) G' for of W res; .� S/•'t; i'�j described below. Owner or Tenant �' .-1 V et l Cj„ a ; ,i- d `` z r. G•-iA O 2 6 2 3 Owner's Address rv1 ,L 1'fh G 1 Telephone No. l Is this permit in conjunction with a building � � ,-Z J . 17Z ` a Purpose in c permit. Yes tyN ❑ (Check Appropriate Box) j Existing Service_ Utility Authorization No.___ �,g f Amps / Volts 1 New erviee Overhead IDUnd rd❑ Amps / g No.of Meters Number of Feeders and Ampacity Volts Overhead 0Und rd g El No.of Meters Location and Nature of Proposed Electrical Work: C 4// Law V614" F Aka;•o v,• a c..,d ems..-r ,. l to , i 'al v6S� vUs � ) C '�? : No.of Recessed Luminaires Completion o the ollowi»•table m No.of Cell;Sus be waived b the/ns,actor o Wires. ,i No.of Luminaire Outlets p (Paddle)Fans o 0 ota ``` No.of Hot Tubs Transformers KVA °t No.of Luminaires Generators KVA Swimming Pool :I., rnd.e ❑ n- .0.amergency No.of Receptacle Outlets nd ❑ Butte Units g ing No.of Oil Burners No.of Switches No.of Gas Burners FIRE ALARMS No.of Zones ks 'o.o t etectton an, i 1' No.of Ranges No.of Air Cond. ota Initiatin' Devices No.of Waste Disposers 'eat 'um Tons No.of Alerting Devices p `um,er •• • �• Totals: .................._._....... eto.o e - ors onta ne, No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW No.of Dryers Local[] run Ccipa onnection Heating Appliances Connection ❑ Omer `o.o "a er KW ecu ty yevices Heaters KW �o•o O.o No.of Devices or E,uivalent No.Hyd He assage BathtubsSins Ballasts Data Wiring: No.of Motors No.of Devices or E,uivalent OTHER: Total HP a ecommun ca ors " ring: No.of Devices or E.uivalent Value of Electrical Work: ` Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimatedo Start: /O2...92r S COOp 2 2 — -- (When required by municipal policy.) WorkINSURANCE CO Inspections to be requested in accordance with MEC Rule 10, ERA E: Unless waived by the owner,no and upon completion. the licensee provides proof of liability insurance includingPaten for the performance of electrical work may issue unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing "completed operation"coverage or its substantial equivalent. The CHECK ONE: INSURANCE I certify,under the pains and penalties 12 o D 0 OTHER 0 (Specify:) office. FIRM NAME: fperlury,that the information on this application is true c�., 1& I i o S- d complete° , ://� P Licensee: c- ke,..-�P f �c� a�b�L�' (Ifanplicable,enter 'exempt"in the license n mbar be.) Signatur LIC.NO.:__ � -- Address: Zv ,E ;S �—� LIC.NO.: Per M.G.L.c. 147,s.57-61 security work requires De artment P.,/ �� Bus.Tel.No.;, `3� _/9/�OWNER'S INSURANCE WAIVER: p of Public Safe Alt.T•el.No.: Orewner/Agent by law. By my signatureI am awre that the Licensee does not have the liability insurance coverage normally Ownred Agent below,I herebywaive this requirement. I am the(check one 0 Signatureg rurally owner I owner's a.ent. Telephone No, PERMIT FEE:$ CJ 5h