The URL can be used to link to this page

Home My WebLink AboutBLDE-23-002703 a Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002703 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:11/15/2022 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) 1069 GREAT ISLAND RD Owner or Tenant ANDREW RICHARDS Telephone No. Owner's Address 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: Wiring for single car garage (Fed from house) 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 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiatintt_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 ❑ 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 Siens 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: Jay A Donnelly 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 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: $75.00 ROU4-411 Cill 711/7 K-e" RECEIVED ,. OV 15 2022 t', ,amaa[h Kekkat44.141116 rail. Bee J Permit No. `��J— _ I O3 4 ,,/ s t,INGDEPARTMEMf'','' %—im areicaa Occupancy and Fee Checked 1 0 :: " PREVENTION REGULATIONS [Rev.1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /f./e-to2aZ City or Town of: ieaNOU 4 To the Inspector of Wires: By this application the tmdersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) letup/ /gAI' 5//j/rJQ 12 D. c�pp y Owner or Tenant /f)D�ij R M�Q/)S Telephone No.'if P--/L1/-/�2$ Owner's Address �O/fa,1�39.rl3e jOtre 5-7e A1.1T. Is this permit in conjunction with a building permit? Yes [ No ❑ (Check Appropriate Box) Purpose of Building C 4I GE Utility Authorization No. Existing Service Amps / Volts Overhead E 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: bares- A t CW .1.oti e G 4 p A c.'F •• PEG' Fgatm INo()se I Completion of the following table maybe waived by the Inspector of Wires. ket lb No.of Recessed Luminaires No.of Cdl.-Susp.(Paddle)Fans No,of Total Transformers KVA 4 No.of Luminaire Outlets No.of Hot Tubs Generators KVA a Above In- No.or Emergency Lighting 4- No.of Luminaires Swimming Pool grad. ❑ gm& ❑ Battery Unite ,, No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS No.of Zones ems. No.of Switches .� No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices rs Heat Pump Number..Tons_ IKW. No.of Self-Contained No.of Waste Di sposers Totals: Detection/Alerting Devlces No.of Dishwashers Space/Area Heating KW ►,eel❑MCunonnection icipal 0 Otbe No.of Dryers Heating Appliances KW No.Security Systems:* Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or E quiva lent No.Hydromassage Bathtubs No.of Motors Total HP Td No.of Devices our 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:#—A/-02.2 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE g BOND 0 OTHER 0 (Specify:) I certify,under the pains� �i and penalties ofQerjnrp,that the Information on this application is true and complete.A FIRM NAME: t),/yr PM/06 II 1 elEC j/I,Tti C 1. LIC.NO.: /r/52/7 Licensee: Tit to Al NE[I/ Signature " LIC.NO.: (If applicable,enter" t"in the license man line) / Bus.TeL No.. Address: /3 .t)V" '.7.- e /¢y/l.I/f/1t L1 AAA..a at74 7 AIL 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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No. • • • • • ; }}.. 1. i.. ..' ...� ... r.. - .j,• • • • _ f • • • •