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Home My WebLink AboutBLDE-23-001535 Commonwealth of Official Use Only r E Permit No. BLDE-23-001535 "_. Massachusetts F`�' 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 IN INK OR TYPE ALL INFORMATION) Date:9/23/2022 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) 481 BUCK ISLAND RD UNIT 19 Owner or Tenant BENOIT ROY F JR Telephone No. Owner's Address C/O MILLS CAROL A,42 BOXBERRY LN,WEST YARMOUTH,MA 02673 / Is this permit in conjunction with a building permit? Yes CINo ❑ (Check Ap}t�Qp Purpose of Building Utility Authorization No. ^tt77��'"7� S Existing Service Amps Volts Overhead 0 Undgrd CI ``14. New Service Amps Volts Overhead 0 Undgrd 0 No.a ,,tot, Number of Feeders and Ampacity • ///�J O��/� Location and Nature of Proposed Electrical Work: Replacement furnace.(UNIT 19-B) h rr Completion of the following table may be waived by t Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of ,V Transformers K No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency Lighting grnd. grnd. jiattery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons 1 KW No.of Self-Contained 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 Sivns 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOSEPH P ROSE Licensee: Joseph P Rose Signature LIC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$50.00 c 9 ys,,,f,,,a ( cia tylop (o4c/i9iu C..oavnonwsa!#o/Vicsimac.L../14 Official Use Only c7 Permit No. ('� ( � it 1 a .d)cc��sparfnutni o{.}in Servicse i((_-; Occupancy and Fee Checked ;, �.� BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Coda(MEC)1527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: 9/,JAL,�Y). �- City or Town of: Ai,,rre‘A.v.-1 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) L- J Bo,,(t 41 c,,.R'] j oi " Owner or Tenant �ryrr 0) IA 1M. . Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1.),LL)YvY,4_0 0, ern(nay c c. •, v) Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total IA Z Transformers KVA C No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units �a1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Z. No.of Switches No.of Gas Burners No.of Detection aid Initiating Devices 1:r 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 l Totals: _..___... Detection/AlerthwDevices No.of Dishwashers Space/Area Heating KW cal❑ Connection al ❑ Lo Other No.of Dryers Heating Appliances KW 'Security Systems:* No.of Devices or Equivalent • No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Egiiuiv��alent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devices or Egquivalent 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 V 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.: ) A Licensee:-5`0L�f k. y n t. Signature yt a., p/02vJ"� LIC.NO.:/ -,7` (If applicable,enter"exempt"hi the lie a gumbo:life) Bus.Tel.No.: 77 tom/ :7—/j Address:�e'S i a {� //' j.,i ti I•Vre/r.-st N. Alt.Tel.No.: 'Per M.G.L. c. 147,s.57-61,slcurity 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 PERMIT FEE: $ Signature Telephone No.