The URL can be used to link to this page

Home My WebLink AboutBLDE-23-002588 Commonwealth of Official Use Only E.. ,E Massachusetts Permit No. BLDE-23-002588 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:11/9/2022 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) 2 BARNBOARD LN Owner or Tenant JACKSON JOSEPH Telephone No. Owner's Address 2 BARNBOARD LN, WEST YARMOUTH, MA 02673 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace and upgrade distribution panel. 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. 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 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 0 Municipal 0 Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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: JAMES E PRECOURT Licensee: James E Precourt Signature LIC.NO.: 12418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:244 S WORCESTER ST,APT 3,NORTON MA 027663445 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: $50.00 tql0 el412,241-e* )--11,),4t_ 04— iL4 /Y_L t RECEIVED . NOV 09 202t . .alfh,/tr/ae L....tb Official Use Z nly ei .. `/`-,� Permit No. a ,•'Cs _ -I", nI of ji,✓,,,,,,l e f�� DING DEPART Occupancy and Fee Checked a . . - -REVENTION REGULATIONS [Rev.1/07] (leave blank) 1 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: 10/05/2022 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) 2 Barnboard Ln Owner or Tenant Jackson Joseph Tdephoae No. 508-916-9254 Owner's Address 2 Barnboard Ln,Yarmouth,MA,02673 Is this permit in conjunction with a building permit? Yes 0 No ® (Cheek Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Need to change out the 200 amp panel to make more room for the taps. Will need to swap the panel and to 200A main breaker with 225 A buss and will do a back feed breaker for solar tie in. v Completion of the following table m be waived by the Inspector of Wires. Total lC No.of Recessed Luminaires Na.of Ceil:Susp.(Paddle)Fans Tr ns� Transformers KVA C. No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting -t No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones F Initiatinnggcti No.of Switches No.of Gas Burners No.of Deteon and Devices II' Total 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 Totals: Detection/Alerti g Devices No.of Dishwashers Space/Area HeatingKW Loral❑Municipal ❑Other P Conoectioa No.of Dryers Heating Appliances KW Security S`vs• No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H ydromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3,007.70 (When required by municipal policy.) Work to Start: 10/19/2022 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❑ 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: James Precourt LIC.NO.: Licensee: 12418 A Signature Ja-m-e-5,Pre crru-s+ LIC.NO.: (If applicable,enter"exempt"in the license number line) Bus.Tel.No.' Address: Alt.TeL No.: •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 have the liability insurance coverage normally required by law.By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Ja.ewe..Frets v-e* Signature Telephone No. 339-201-7769 PERMIT FEE:$ _ The Commonwealth of Massachusetts Department of Industrial Accidents d -•"fit.:. 1 Congress Street, Suite 100 _t=?miaow Boston, MA 02114-2017 =,•�'•v www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): Summit Energy Group Address: 15 Berkshire Rd City/State/Zip: Mansfield, MA, 02048 Phone #: 339 201 7769 Are you an employer?Check the appropriate box: Type of project(required): l.®1 am a employer with 10 employees(Pall and/or part-time).' 7. 0 New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp. insurance required.] 3.❑1 am a homeowner doing all work myself t 9. Demolition❑ y [No workers'comp.insurance required.] 4.0 I am a homeowner and will be hiring contractors to conduct all work on mY Property. !will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 1 1.0 Electrical repairs or additions proprietors with no employees. 12.E Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.: 13.D Roof repairs 6.0 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.®Other Solar 152,§1(4),and we have no employees. [No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Colony Insurance Company Policy#or Self-ins.Lic.#: 001120909 Expiration Date: 01-01-2023 Job Site Address: 2 Barnboard Ln City/State/zip: Yarmouth, MA, 02673 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: JwYfuti Kro-gtA-e Date: 11/01/2022 Phone#: 339-201-7769 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: