BLDE-23-000232 . .4.\
Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-000232
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:7/14/2022
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) 38 TOURAINE WAY
Owner or Tenant Patricia Behan Telephone No.
Owner's Address 38 TOURAINE WAY, SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Me rs
New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete
Number of Feeders and Ampacity /
Location and Nature of Proposed Electrical Work: Wiring for heat pump. }o �
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 1 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 1 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 I Number Tons KW No.of Self-Contained
I
Totals: 1 I 2 Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Municipal Local ❑ 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:)
1 certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: ANDREW G THOMAS
Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:7 ECHO LN, CHATHAM MA 02633
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: $75.00
"'' Commonwealth, Official Use Only
o/ a�eac u�etts
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C� Permit No. 23—a T77;7; �jeparlment o/.}ire Jervicei
� BOARD OF FIRE PREVENTION REGULATIONSOccupancy 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
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 5'115 ct)'a 2
City or Town of: YA(1 071, d Al of 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) - IOU Ca I n - (N 9 5
Owner or Tenant V k 4 t.(i,1 13 C. h k n Telephone No.
Owner's Address )8 Tour": L,k4
Is this permit in conjunction with a building permit? Yes ❑ No Of (Check Appropriate Box)
Purpose of Building ces t 1t,t.141 t Utility Authorization No.
Existing Service 10 o Amps '1)1' / a 4dVolts Overhead ❑ Undgrd l
g � No.of Meters
New Service Amps / Volts Overhead El Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: lyt, ,,i ) 7-c n t 1+e.,i t t//ti P
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 t 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. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: 1 ).. Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or Equivalent
No.of No.of
Heaters KW Signs Ballasts llata Wiring:
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: law (When required by municipal policy.)
Work to Start: SKIS -7,1.o4 1 Inspections to he 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 [I BOND ❑ OTHER ❑ (Specify:)
I certi under thepains andpenalties operjury,that the information on this application is true and complete.
.fY, ./�
FIRM NAME: `rtw NIS ti Gc.''r,cy I 5 stV c•c( LIC.NO.: 2415'41-A
Licensee: Ancl ' t' ThoreJ Signature
(If applicable, enter "exempt-in the license number line.) LIC.NO.:
Address: �C�o dun ti (►,1,q I b�,r (�+k, va 4/1Bus.Tel.No.: te 17 - ;3h-3 7 7-3
No.:
*Per M.G.L.c. 147,s. 57-61,security work requires Department of Public SafetyS"License: Alt.Lie.el�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's agent.
Owner/Agent
Signature Telephone No. I PERMIT FEE: $