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Home My WebLink AboutBLDE-23-003584 .. Commonwealth of Official Use Only Massachusetts Pennit No. BLDE-23-003584 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•12/31/2022 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) 25 BROWNING AVE Owner or Tenant STEPHANIE ERICKSON Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 :lmpacit Location and Nature of Proposed Electrical Work: Replacement panel,air handler, &condenser. 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 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: JOSHUA B DEJOIE Licensee: Joshua B Dejoie Signature LIC.NO.: 53490 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 10 LEXINGTON LN,YARMOUTH PORT MA 026752437 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 N114- 113/ 3C Qe- (��/� �� • RFoCF ; vED E tJ 4 •_.T1 F.., 1, (fir oiMassachusettsOfficial Use Only ommonusea C Y " i:A�•_+[t �] /`J Permit No. Ci2 —3 L( �.:^� i I 2)epartns.nt o/-Jire Serviced B U I L ua�ti._, .!(-=�;.E w_ Occupancy and Fee Checked ARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] � (leave blank) a APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 'J All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 k (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I).-).0-a'4_ City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives noticef� of his or her intention to perform the electrical work described below. Location(Street&Number) as �)Ci14,lnit, fk.[.t Owner or Tenant a ' .qi e. 1-c C GCS c n� Telephone No. r7'�ti 7,Z1 I I a k.� Owner's Address a c 001-1 Pot f J Is this permit in conjunction with a builMAg permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building t)'(,JL\`.((\q Utility Authorization No. S Existing Service I DO Amps /- Volts Overhead 7 ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters / Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: �;Ce- S{Q\0.ct_rte-sk �sC \akc..N&VQ.r r es 1�G-(G2P OUVS�Ue., NC. 1 ?\ckcQ, 7G(Ng Completion of the followin table may be waived by the Inspector of Wires. Us No.of Recessed Luminaires No.of CefL-Soap,(Paddle)Fans To 1 otal ni Trannss formers KVA VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA k• No.of Luminaires Swlmmin Pool Above In- No.of Emergency Lighting g stud. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices II, No.of Ranges No.of Mr Cond. Totalo No.of Alerting Devices No.of Waste Disposers Heat Pump Number„Tons KW No.of Self-Contained Totals: ..__..........-..._.--. ��""'. Detection/AlerthrgDevices No.of Dishwashers Space/Area Heating KW Local 0 CoMunicipalnnection 0 Omer No.of Dryers Heating Appliances KW Security SysNo.of tems:. No.of Watereat No.of No.of Data Wiring:ingvices or Equivalent Signs Ballasts No.of Devices or Equivalent No.Hydromaseage 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: Q.Doc, (When required by municipal policy.) Work to Start: I).-.).0--Y.a 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❑ OTHER 0(Specify:) I certify,under the pggps and penalties oper1ury,that the information on this application is true and complete. ,yq FIRM NAME: Joij`1J c)c,. LJc.,Z E1-ec., �C,:w LIC.NO.: /J3'` ll)-3 Licensee: 'I;q\Ot. nte,- a Signature (if applicable,enter"exempt"in the license ee number tine.) LIC.NO.: Address: Bus.Tel.No.: r1Zy gyL{OL{f33 TNo.: *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License:AIL Lie 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. 1 am the(check one owner owner's a eat. Owner/Agent Signature Telephone No. PERMIT FEE:$