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Home My WebLink AboutBLDE-23-004734 w . Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004734 t BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked . jRev.1/071 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/N INK OR TYPE ALL INFORMATION) Date:2/27/2023 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) 28 SATURN LN Owner or Tenant Aaron Saniuk Telephone No. /\ �� Owner's Address /v-pi) Is this permit in conjunction with a building permit? Yes ❑ No 0 (ChMrop Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 V o of/I�M?4.8?k--- Location New Service Amps Volts Overhead 0 Undgrd 0 R,C_/'''Y` /`�J7 Number of Feeders and Ampacity V and Nature of Proposed Electrical Work: Permit work done by others. Completion of the following table may be waived by the In r 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. ❑ Na.of Emergency Lighting grad. grad. 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 Initiatintr Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Dis posers Heat Pump Number Tons KW Na.of Self-Contained P Totals: Detection/Alertine 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 Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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:) �p I+j -27'4�/Z 2.. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Ray W Bombardier Licensee: Ray W Bombardier Signature LIC.NO.: 33621 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 2443,MASHPEE MA 026498443 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 1{2$12."3 102g_. (spades A r 1114-,f up k sSuE wtxts Nort2viv) M V( 23 arg,ttat r- 4 � R � RECEIVED • "I" Official Use Only_ B 2 4 20Jrn nwealth of Massachusetts r /, Permit No.: L�7"t_t 7�tf �,pti��,t�_Dht�e artment of Fire Services Occupancy and Fee Checked: teOHKU Vr IRE PREVENTION REGULATIONS [Rev.1/2023] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 CM 12. City or Town of: YARMOUTH Date:_ Y To the Inspector of Wires:By thi ap'Motion,the undersigned gives nob of l or her intention to perform the electrical work described below. Location(Street&N J her): A-TU.2 N [L Unit No.: Owner or Tenant: ((44 d-0 A-S IA f-12.(Z t ICJ f Email: Owner's Address: 5 A,vs-e S Pr tV t V I&. �,/Phone No.: 5'bY ')-7 4, is' F � Is this permit in conjunction with a building permit?(Check appropriate box)Yes 1r wo❑Permit No.: Purpose of Building: W I .ire-(LIZ e 4 2eeze L✓A)t Utility Authorization No.: Existing Service: (0 0 Amps j)-O/Az/Volts Overhead Q"Underground❑ No.of Meters: I New Service: Amps / Volts Overhead 0 Underground 0 No.of Meters: . Description of Proposed Electrical Installation: Pe [S V t�t:Ti t nAC l NI S PeC.TC,2_ Ave et cCYL t C I✓f rU 'c S P'.L 1- u3.1 r-t[v ve Do - 3v wl C C rr2,4Crat. ,N, .4 o wt Completion of the following table may be waived by the Inspector of Wires. ° f No.of Acceptable Outlets: No.of Switches: Generator KW Rating: Typ'e:.„� No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW lketulr6>j, ,/0 No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: ///`�j✓ Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: �/��iVCr3�) No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Grad.❑ Above-Grnd.0 Hot-Tub 0 No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount❑ Ground-Mount 0 Level 1❑ Level 2❑ Level 3❑ Rating: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4 Oe*n (When required by municipal policy) Date Work to Start: f/).if Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: n, Wt.VtJ 9 t 1.8,0 pt-t j-,J)tL. A-1 0 or C-1❑LIC.No.: 33 toe/V-1 Master/Systems Licensee: LIC.No.: ^ Journeyman Licensee: 1 /Wt 0"-)-0 t„8 p I01312_Dvel_ LIC.No.: 3 3 Ce2(^tr Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: e 01 3 t' J k Qf 3 1v 5(�e /t'1/t-, O�(o t{7 Email: r w Yy D N^ G.I r___.)t P_2 ? rl'tCi6 1 -e014Velephone No.: �S---d1 Z 419 ov-S'.� I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: Print Name: Cell.No.: INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability 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: 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 ant the:(Check one)Owner 0 Owner's agent 0 Owner/Agent: Tel.No.: Signature: Email.: