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Home My WebLink AboutBLDE-22-006632 l rpeCommonwealth of Official Use Only -- `' Massachusetts Permit No. BLDE-22-006632 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked LRev.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:5/17/2022 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) 12 SALTWORKS LN Owner or Tenant GREW THOMAS A Telephone No. Owner's Address GREW VIRGINIA A,2 ATLANTIC AVE, SOUTH YARMOUTH, MA 02664-1610 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App priate Box) Purpose of BuildingUtilityAuthorization No. 6 g � 3 4 176 P e � ��b'Y- Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters N� New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters t/ Number of Feeders and Ampacity // 7 Zy Location and Nature of Proposed Electrical Work: New residence(3 inspections) 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. 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 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 ❑ 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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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 /2z& P—t—tN3pCalvor7) e§,y,L.`1 L(x,lis tri_ QUOIA-- <4/ze 6 ( 7/24f7,2, k 9 ecy 423 pi, (a.. 6--ecr...ke-n.3 v- ra tt i` c Ali:-714�.n1 R-1Ai uraZ: (ti,rei li)/t OCz..9 L Commonwealth of Massachusetts Official Use Only Z- Vii t Permit No.� -1//L/l(JcJZ ., Department of Fire Services (` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked • ,,-„� [Rev.9/051 (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: Maw I Ic, j-0.3t r City or Town of: (n)n'1c-'w 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) 12 ,\(�- (�-, LA Owner or Tenant ` ;,,-,c\ (-1,,( Io,) Telephone No.TN o_u.3 si-j; 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 i oa Amps 1 ZD 12. Volts Overhead® Undgrd❑ No.of Meters Number of Feeders and Ampacity ^. Location and Nature of Proposed Electrical Work: NV C) C(1 LiL?_ i rUi: 1,V c V t s),l Lk h vc._ Completion of the followitt&(able may be waived ba the Inspector of Win es. tal No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf _ Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Pool Above In- 'N lmergency Lighting Na.of Luminaires Swimming 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 ana Initiat5 Devices No.of Ranges No.of Air Cond. Total No.of AlertingDevices g Tons No.of Waste Disposers Heat Pump „Number Tons KW No.of Self-Contained Totals: IDetection/Alerting Devices No.of Dishwashers Space/Area Heatirg KW (Local❑Municipal ❑Other _ Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent 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 proot of same to the permit issuing office. CHECK ONE: INSURANCE U BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 4 NE I-.ECTZ\C I I NC.. LIC.NO.:`rj3QLy-Q Licensee: TIL E1?, W yNE Signature %�4e LIC.NO.:72.6• - (If applicable,enter"exempt"in the license number line �" - / ®_ Bus.Tel.No. M .t Address: 20. BOX1n'iCi SOOT LiH \Al Val,MIA02.0lo1 Alt.Tel.No.: liTr :a1 *Security System Contractor License required for this work;if applicable,enter the license number here: 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)I-1 owner ❑owner's agent. Owner/Agent Signature _ Telephone No._ PERMIT FEE:$