BLDE-23-001712 j ) Commonwealth of Official Use Only
'E / Massachusetts Permit No. BLDE-23-001712
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.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:9/29/2022
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) 104 PLEASANT ST
Owner or Tenant A.J. LUKE Telephone No.
Owner's Address SOUTH YARMOUTH, MA 02664
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: Install generator&transfer switch.
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 1 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
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 ❑ 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: PAUL J VIOLETTE
Licensee: Paul J Violette Signature LIC.NO.: 20858
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 18 ANCHOR DR, FORESTDALE MA 026441822 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: $75.00
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' 'REVENTION REGULATIONS Occupancy and Fee Checked
J fit. .• '• • (Rev.1/07j
(leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
f All work to be performed in accordance with the Massachusetts Electrical Code( EC), 27 CMR 12.00
'�,./ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 g�a
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of bis or her intention to perform the electrical work described below.
Location(Street&Number) /Q / p/Q4„. 4 S
Owner or Tenant 4 v L,�- Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ®".---(Check Appropriate Box)
Purpose of Building ) F4 i✓! Utility Authorization No.
Existing Service�t f1 D Amps /, t l d Y 0 Volts Overhead❑ Undgrd[" No.of Meters
5 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
(� Number of Feeders and Ampacity
!a Location and Nature of Proposed Electrical Work: rn 4-0// ( _ } +Y e,'t_S
S't.,f
\-t Completion of thefollowingtable mcry be waived by the Inspector of Wires.
'! No.of Recessed LuminairesNo.of Cell:Snap.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool grbovad.Ae ❑ In-grnd. No.ofBattery EmergencyUnits Lighting
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
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❑latectlon ❑Other
No.of Dryers Heating Appliances KW Security No. f Devices or Equivalent
No.of Water s KW No.of No.of Data Wiring:
HeaterSigns Ballasts 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 coovera�is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE Tr-BOND❑ OTHER 0 (Specify:)
I certify,under the pans and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Mask 4-U., F) c rtt` LC-C. , LIC.NO.: R(s7AI
Licensee: ()r, ,I J- J,n 1, (! Signature J70.,,�_,„)r ) LIC.NO.:,.2 O.?Ts/-)
(If applicable,enter"excerpt"in the licensgnumbel:line.) fi Bus.Tel.No.'
Address: /F t9/iG IIdr 6— -Fore.`4 4_ riA 1 6 c/y Alt.Tel.No.:6-ea-Zol-S3'->S
'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 hate 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:$