HomeMy WebLinkAboutBLDE-23-003013 Commonwealth of Official Use Only ,.4
E. Massachusetts
Permit No. BLDE-23-003013
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:12/1/2022
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) 7 BURNING TREE LN
Owner or Tenant NADEAU JOSEPH M Telephone No.
Owner's Address 7 BURNING TREE LN,SOUTH YARMOUTH, MA 02664
Is this permit in conjunction with a building permit? Yes 0 No 0 (Ch pro j• Box)
Purpose of Building Utility Authorization No./ Ar
Existing Service Amps Volts Overhead 0 Undgrd /4;,' Ne.of M __/
New Service Amps Volts Overhead 0 Undgrd"",13' • No•of Me ,
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install generator
Completion of the following table maybe waived'by the Inspector of Wire
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans ' No.of '�4 F' E „:\, Total
_Transformers I KVA
No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 14
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. To
No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained .rh"�
Totals: Detection/Alertine Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 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 Siens No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices wr Eauivaleut
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wir
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 ofperjury,that the information on this application is true and complete.
FIRM NAME: FRANCIS D JONES
Licensee: Francis D Jones Signature LIC.NO.: 13534
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:309 Neck Rd, Rochester MA 027701700 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: $80.00
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1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev, 1/07] leave blankAPPLICATION FOR PERMIT TO PERFORM •
WORK
M1 work to be performed in accordance with the Massachusetts Electrical Code(MEC 527 CICA R 12.00
(PLEASE PRINT WINK OR 774 ESL 100x TION) date; 1 ,,+
City or Town of: ----� . a
•
�--- �'0,02 T To the 1'nspectm^of Wires;
By this application the undersigned gives Cayce of his or her intent' 1 to perform the electrical work described below,
Location(Street&Number). iNh` r
Owner or Tenant•
, —�C'
Owner's Address _ _ Telephone No, W'
Is this permit in conjunction with a buildin �� --�� `r?'tf
b permit? Yes
Purpose of Building -- N0 I (CheckAppropriate Box)
Utility Authorization No,Existing Service Amps /
________Volts Overhead : Undgrct,] No,of Meters _
Neyv Seryiee Amps /
Number Feeders and Ampsit Volts Overhead,� Undgrd 0]. No,of Meters ____
Location and Nature of Proposed ElectricalWork;
co
. . • .
. • -------7--------------------
Completion o the follow be waived by the Ins ectoa o Y'ires,
l tJ No,of Recessed Luminaires No,of Ceil,•Susp,(Paddle)Fans °,° -"��"�' eta
No,of Luminaire Outlets Transformers r�VA
16 o, of l Ion Tubs Generators Z{VA No,of Luminaires eve ❑ in- _.-
•
Swimming Pool arnd o,of mergelcy rg r ng
No,of Receptacle Outlets rnd` ❑ —....Batter Units
No,of Oil Burners M_
74V
1;of Switches FIRE ALARMS No,of Zones
No,of Gas Bw news ----_,._—
730,o i stet on an:
No,of Ranges ova , _ - of
Ale ti Devices
No,of Air Conch Tons No,of Alerting Devices
•
No,of Waste Disposers eat ump um er ens
Totals; ,,,,,., No,o e • 'ontame:
No, of Dishwashers Detection/Aiertin Devices •
Space/Area Heating K Local❑ Tunicipa
No,of Dryers Heating A tierces _ systemConnection ❑ Other
o,.o ate '-"�' g pp ICW cur ty. systems:"
•
Devices
Heater • IOW o,o 0 0 No,of suites or Maui valent
Si ns Ballasts Data Wiring;
No, Iydromassage Bathtubs No,of Devices or E uivalent
No, of Motors Total ZIP Telecommun cations• it ng;
•
OTHER; No,of Devices or E uivalent
Estimated Value of Electrical Woy ,-' r Attach additional detail lfrlestrer!m'ns reriith'ed by the Inspector of IYbes,
EWork tostimat Start; V� �-'�----- t_._ ( when required by municipal policy,)
INSURANCE COVERAGE; Unless waived by tections to hrequested
wne,no�permit for the performance
of electrical
and upon complytissu
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent,electrical work may issue unless
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office,
CHEF GIB ONE; INSURANCEq t, The
I cerd�`y,under the patns,anrl peCn�rtltle BOND ❑ OTHER ❑ (Specify;)
FIRM.NAME; i f el:My,that the infornzatton on this application true and complete,
Licensee; lQ 1'1��S l7� LIC,.NO.,; T` O�
' (If applloagle,enter' "e•ehv t"In the license Innn er lin , Signature ����� /' "(�
Address; `� L mac.X IC,NO,:� - ,�`� !
"Par M,O,L,c, 147,s,57-6I,security work requires b Bus,Tel,No,;
• OWNER'S INSURANCE WAIVER; I am aware that the Licensee does not have the liability insurance coy
partment o•Public Safety"S"License; Lie,No,
required by law. By my signature below,I hereby waive this requirement, I am the(check one ❑
Owner/Agent swage normally
Signature • ) owner []owner's a ent
Telephone No,..______________ E�E1�1i2zT PE `