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Home My WebLink AboutBLDE-23-003710 or Commonwealth of Official Use Only ,E. Massachusetts Permit No. BLDE-23-003710 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1Rev.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:1/9/2023 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 bel Location(Street&Number) 441 BUCK ISLAND RD UNIT EE 1()N l"' Owner or Tenant CHENEY JOSEPH M JR TRS KA(2 e/.I I(\t fr r-iim2 iNfir Jelexhone No. Owner's Address FRENCH PRISCILLA J TRS,27 SCHOOL ST STE 301,BOSTON,MA -li)FT-1— Is this permit in conjunction with a building permit? Yes❑ 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: Split NC system 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 ernd. 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. 1 TTotal No.of Alerting Devices 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water ICy No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eouivalent 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JESSE R LING Licensee: Jesse R Ling Signature LIC.NO.: 15646 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 1200,WEST CHATHAM MA 026691200 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,1 hereby waive this requirement.I am the(check one) ❑owner 0 owner's agent. Owner/Agent Signature � Telephone No. PERMIT FEE:$75.00 k ((1 23 ee ..- -.- Qe&aL' fowl • - rik' . _ Fc: Official Us my�` r E. I _ - E=: C . PrucQ of Ma66uC/usa IPermit Nc �2J- 37 Lflit= " ' - ... . . ! - !__ • cp• rf o f_7.ra Scrviccs • = - = O is 1 1 20z2 Occupancy and Fee Checked • y..-` BOARD OF FI E RE.,,mi, VENTlON REGULATIONS ev. 1/07] (leave blank) A P PL1GA - - -0 L . 0 ' 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 INFORIL4 TION) Date: to z - °).- City or Town of: YARMOUTH To the Inspector of Wires: . By this application the Itindersigned gives notice of his or her ' tention to perform the electrical work described below. Location (Street & Number) (- y f3 c ik U A- • Owner.or Tenant\'CA-t- .e,� Telephone No. 4 � 79 � � Owner's Address UL� G uN Is this permit in conjunction with a building permit? Yes No L (Check Appropriate Box) — • Purpose of Building V i ' ),\ Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd n No. of Meters New Service Amps / Volts Overhead E Undgrd ❑ No. of Meters Number of Feeders and Arnpacity Location and Nature of Proposed EIectrical Work: t1. ‘- N 4 t_c"_ elik (Ac a\-- cr /44-c- Pit.\-75)-,-_itv\ 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 Tansformers KVAVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- No. of i.mergency lighting Swimming Pool ornd. ❑ arnd. Q 'Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS JNo. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No.. Alerting Tonsof Air Cond. Total No. of Devices No. of Waste Disposers Heat Pump Number No. of Self-Contained Totals: f.Tons ��HKW— - !Detection/AIertIna Devices No. of Dishwashers Space/Area Heating KW' !Local Q Municipal Q Other Connection Security Systems: No. of Dryers Heating Appliances KW rris:' No. of Water No. of Devices or Equivalent Heaters KW No. of Ballasts Data Wiring: Signs No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent I OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: SOO (When required by municipal policy.) Work to Start: (� P P y 'ell-- Inspections to be requested in accordance with MEC Rule I0, 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 cover is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties operjury,P f that the information on this application is true and complete. p -/ FIRM NAME: L� — J�__ii iL� � n I LIC. N 7(G Licensee: Signature LIC. NO.: (If applicable, enter "exem t" in the li erase mb r line.) Address: a. Bus. Tel. No.: -'- 1 *Per M.G.L. c. 147, s. 57-61 , security work requires Depai tinent of Public Safety "S" License: Alt. Lic.Tel No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage� g normally 5 required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. 7 Owner/Agent J Signature Telephone No. PERMIT' FEE_ $ 7