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Home My WebLink AboutBLDE-23-002024 oiF r .. Commonwealth of Official Use Only .E.. „�, Massachusetts Permit No. BLDE-23-002024 • 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:10/17/2022 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) 49 VACATION LN Owner or Tenant TONY CIVLLA 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: Heat pump&air handler. 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 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: 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 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: William F Dougherty Licensee: William F Dougherty Signature LIC.NO.: 13932 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 LOWELL DR, ORLEANS MA 026534841 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 I RECE VED OCT 14 2022 C�, nwaatth.o j Maedachuoatle eial Use Only ;� w 23 z a e��R�ym:a ., i cc''77 nn Permit No. � w ^- �•"'°i )i iV v is E I'.4 t�2 i Nl>_ aflartmanf o�}Ira&micae !la, Occupancy and Fee Checked BOAR! FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C (M ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 v f u ti6 2-2— City or Town of: YARMOUTH To the In pector of Wires: By this application the undersigned gives notice of his� i or her intention to perform the electrical work described below. Location(Street&Number) 1 q (Jac ci-t'r`4 h. (,�am—e- Owner or Tenant T6 K y C I U(I ee Telephone No. Owner's Address / Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building C�i fvi Utility Authorization No. Existing Service we Amps 71/0/(2 a Volts Overhead[A Undgrd I g C No.of Meters New Service Amps / Volts Overhead El Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Qd LYoxi 4i- ,,,, A-60-4'vim, aiMet,v4eZer I) . Completion of the following table may be waived by the Inspector of Wires. tit No.of Recessed Luminaires No.of Cei1:Susp.(Paddle)Fans No.ofTotal KVA G,J Transformers KVA .1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA "t No.of Luminaires • SwimmingAbove In- No.of Emergency Lighting Pool grnd. ❑ grnd. ❑ Battery Units a 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 II! No.of Ranges No.of Mr Cond. Totalo No.of Alerting Devices 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 Data Wiring: HeatersSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : No.of Devices or Equivalent OTHER: ,,i Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El trical Work: �fp'�.a"D (When required by municipal policy.) Work to Start: e /y '2-11 2 2• Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O ERAGE: 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 p., 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: LIC.NO.: Licensee: / /tvlvt t. dd ii.er-/— Signature LIC.NO.:41932-5 (If applicable, 3ter"ex tnpy"in the licensee numb r line) Bus.Tel.No.•?7t/'722-40 7gi Address: �G4wirf( t✓riv-e Ore 1 otpf-a�53 Alt.Tel.No.: 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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. PERMIT FEE: $