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Home My WebLink AboutBLDE-22-003126 or Commonwealth of Official Use Only .4.. , Massachusetts Permit No. BLDE-22-003126 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/N INK OR TYPE ALL INFORMATION) Date:12/1/2021 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 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 400 Amps Volts Overhead 0 Undgrd 0 N . Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence 4 Completion of the followin ,,,t• .' ,e he Inspector of Wires. No.of Recessed Luminaires 110 No.of Ceil:Susp.(Paddle)Fans 1 No.of Total Transformers O VA No.of Luminaire Outlets 12 No.of Hot Tubs 1 Generators VA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Ligh ' grnd. grnd. Battery Units n No.of Receptacle Outlets 85 No.of Oil Burners FIRE ALARMS No.of Zon V No.of Switches 65 No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. 4 Total 10 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 2 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances 1 KW 2.9 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: 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: $180.00 V "1 4t- ' /f'0,00 Commonwaa[th 4///m9achtwtld Official Use Only J o 111 to 2epartment o`Jire&pekes O 1.11: Occupancy and Fee Checked Li) c t BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK E;,; All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 r,L..-. (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: /7-3'o o2l 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& r//f 11 Ern-1��'/ ji49 j2 Owner or TenantAOam 1ZZi .. Telephone No. Owner's Address 67X '.6-,4:Z9 r/U; ',US!/T �7ya/ Is this permit in con)unc on cwith a building permit? Yes {j'No(�' ❑ (Check Appropriate Box) Purpose of Building dFf ' am Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters /�•/ ��j��New Service Pr. k.i, olts Overhead❑ Undgrd P Na.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (,„Js /i?.J G)0 ff19/4.6- \rr Completion of the following table m be waived by the Inspector of Wires. ,rt / any U No.of Recessed Lnminairea//Q No.of Ceil:Sosp.(Paddle)Fans / No.of Total " Transformers KVA Cam,\ No.of Luminaire Outlets /r . No.of Hot Tubs / Generators KVA ,I- No.of Luminaires Y� Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. grad. Battery Units - No.of Receptacle Outlets Ey. No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches �� No.of Gas Burners / No.of Detection and Initiating Devices 't' No.of Ranges / No.of Air Cond. ! Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons No.of Self-Contained Totals: .. ...._ _.._....... - - Detection/Alertln Devices No.of Dishwashers a Space/Area HeatingKW Municipal / Local❑Connection El Otb� No.of Dryers / Heating Appliances/ KW^�9 Security Systems:. No.o!Water • No.of Devices or Equivalent No.of No.of Heaters KW Signs Data Wiring: 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:/0 30 c / 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Ur BOND❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: .c.1 ,6oA]p1)FjIY,41 -2-:7-AIl- a. /f/� LIC.NO.:�/J�,7 Licensee: CS ' ( SignatureZa u1/�J_ .,r, LIC.NO.:,1/5 (If applicable.enter"esempt"in the license number li e Y77 _Gy Address: /0 z-L/� / ) Bus.Tel.No �" s i r (/ I4' l 27 7 Alt.Tel.No.•.9ci:3 R�3-��/, -•Per M.G.L.c.147,s.57-61,security work requires Department a 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 ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$