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Home My WebLink AboutBLDE-21-006562 Commonwealth of Official Use Only L. ,,% Massachusetts Permit No. BLDE-21-006562 '`:,.,0 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:5/12/2021 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) 1069 GREAT ISLAND RD Owner or Tenant NOLEN WILSON Telephone No. Owner's Address 1120 5TH AVE APT 10B, NEW YORK, NY 10128-0144 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) oe 1 Mer Purpose of Building Utility Authorization No. '55 r •Q G-"/Ili 21617 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters it L�'('Z2- New Service 400 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. Completion of the following table may. left. ed by the Inspector of Wires. ' No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of �. Total Transform .r . KVA No.of Luminaire Outlets No.of Hot Tubs Generators .> O KVA No.of Luminaires Swimming Pool Arnd.e ❑ I rn ❑ No.of Emergent i tOy g g d Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.o / a O 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 4:O 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs 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: 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.7�� 29�C 'i (� FIRM NAME: JAY A DONNELLY / ` �?v Licensee: Jay A Donnelly Signature LIC.NO.: 15717 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 158 PINE ST, RAYNHAM MA 027671121 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 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 Thz.,,,,01 4Co x 0 cr (P/- A-)5/31 / , t"1c lN6 ( : s u'tcf., C4Qu14, i(2512,z-c iU c Ge-- c a c(4/-72J4e t Cvt?lii 4 I 1 Li 7-3 7FCFIV ' ® . �:A ,, Co>�urwrw.al7Jk o/ri/amac�iae.lfe Official Use Only MAY 1 2 2 i '' ' Permit No. e-�—GS 6PZ H 1Jlptrmnant o/.�in..'.roicre � LDIN(�D�4'A F.i-, Occupancy y., and Fee Checked _._BOARD Or FIRE OREVENTION REGULATIONS [Rev.1/07] (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: 5/f o21 City or Town of: (it,)t i-gjtAO(/ 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) /iii7,)„- T5/1*'QIv j�. Owner or Tenant Wes(5Q ('A-Ai2D5 Telephone No. Owner's Address 017A7 .7,41) 4Prc jffpac,d-ba eki/V ., A -ayy Is this permit in conjunction with a building permit? Yes [u/No L j (Check Appropriate Box) Purpose of Building/2&17-4.O,f I� Utility Authorization No. Existing Service , Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service i�.v., Amps/070 1 .W Volts Overhead❑ Undgrd igrr No.of Meters •r/ Number of Feeders and Ampacity 4 -eRi't7'-' 304 Location and Nature of Proposed Electrical Work: _77 /574-// ii/670 '(',4- SQL .. 7 -floras Completion of the followinktable mg be waived by the I ector of Wires. No.of Recessed Luminaires No.of Ceil.-Sa (Paddle)Fans No.of Total Transformers KVA Q No.of Luminaire Outlets No.of Hot Tubs Generators KVA a Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones t No.of Switches No.of Gas Burners No.of Detection and FInitiating Devices I U No.of Ranges No.of Air Cond. Togs No.of Alerting Devices No.of Waste Disposers 'Heat Pump Number Tons KW......... No.of Self-Contained Totals: DeteMiodAlertlngDevices No.of Dishwashers Space/Area Heating KW Local❑Municinnectiopaln 0 Other C No.of Dryers Heating Appliances KW Security of DevicSystems:* or Equivalent No.of Water KW 'No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationNo.of Devices or EgW uivalent 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: 5//—o''J 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 covers a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE®'BOND 0 OTHER 0 (Specify:) 1 certify,under the pal a penalties of perebery,that the information on this application is true and complete. FIRM NAME: t�,/�{cW/fi /[Y 6J LIC.NO.:/�j 57/7 Licensee: S4.094l.V /lf / Signature LIC.NO.: V5 tC. (If applicable,enter' emp'rn the license number,lined ,',,.'•' Bus.TeL No.' �V6 Address: 1 fly J T:e_AVXIIMNT 4s Alt.TeL No.• 35 •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 PERMIT FEE:$ Signature Telephone No.