HomeMy WebLinkAboutBLDE-23-004333 Commonwealth of Official Use Only
t 411i Massachusetts Permit No. BLDE-23-004333
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 CM R 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORAIATION) Date:2/6/2023
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) 70 WEST GREAT WESTERN R
Owner or Tenant Starbuck Construction Services Telephone No. 5088277134
Owner's Address
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap r,o{p-�ria
V Box)
Purpose of Building Utility Authorization No. f Jzf' .3 A6
Existing Service Amps Volts Overhead 0 Undgrd 0 o.of Meters
New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters V �;, h n,
Number of Feeders and Ampacity .`
Location and Nature of Proposed Electrical Work: Electrical-New house 508-245-7155
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
Initiating 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/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 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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: EAV SOLUTIONS
Licensee: JEFFREY S DEROUEN Signature LIC.NO.: 22206
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 110 Hedges Pond Road,Plymouth MA 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:$180.00
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FEB0 Commonwealth o1adaachuaetfn Official Use Only
' ,t Permit No. B E--23-Ob�333
iH apartment o� ire�ervicea
BUILDING DE`: 1�— "
By _______ r _ BOARD OF FIRE PREVENTION REGULATIONS Rev.1 07]y and Fee Checkedn )
(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: 1/24/23
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) 70 West Great Western Road
Owner or Tenant Starbuck Construction Services Telephone No. 508 827-7134
Owner's Address 176 Sudbury Lane Hyannis, MA
Is this permit in conjunction with a building permit? Yes n No (Check Appropriate Box)
Purpose of Building House Utility Authorization No. 10604483
Existing Service Amps / Volts Overhead ri Undgrd No.of Meters
New Service 200 Amps 120 / 240 Volts Overhead Undgrd ✓ No.of Meters 1
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: New house with a 200 amp underground service
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
1 Initiating Devices
Tot
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
Heat Pump Number Tons KW No.of Self-Contained
No.of Waste Disposers
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 Devices or Equivalent
No.of Water No.of No.of
Heaters KW Signs Ballasts Data Wiring:
g 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: 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 ✓❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: EAV Solutions, LLC LIC.NO.:860 Al
Licensee: Jeffrey Derouen Signature C. Z6.47Z7P� GaO.L� ,rL LIC.NO.:22206-A
(Ifapplicable, enter "exempt"in the license number line.) Bus.Tel.No.:(508)245-7155
Address: 110 Hedges Pond Road Cedarville, MA 02360 Alt.Tel.No.:(781)589-5692
*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: $180.00