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Home My WebLink AboutBLDE-23-003641 Commonwealth of Official Use Only Nit Massachusetts Permit No. BLDE-23-003641 e..' 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:1/5/2023 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 below. Location(Street&Number) 1 HOOVER RD Owner or Tenant PETER MOULTON 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: Replacement furnace (Crawl space) 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- ElNo.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 1 No.of Detection and ,Initiating 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 0 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 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: JOSEPH P ROSE Licensee: Joseph P Rose Signature LIC.NO.: 21335 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Beverly Rd,West Yarmouth MA 026733559 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 SD. JO ' RECEIVED . o eaUh 4 rr/aesachiaaW Zn? S Li/ JAN C 4 20 cc77 i Permit No. to e of of Jin. ervicee )I t`tb(AlibP6 1F4I TP EV NTION REGULATIONS Occupancy and Fee Checked ____ - [Rev.I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electricalc,«/1c( C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '/(-))/ 3 City or Town of: YARMOUTH To the 1 sp ctor of Wires: By this application the undersigned gives notice of his or hr intention to perfo,rm the electrical work described below, Location(Street&lyp r) ) (')Chit' t.� siGf 1 I PJtii i1 Owner or Tenant e Gf ()(A tOYel Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ 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: RcvJ1 r6 A u fpq,e,z t Yl Craw\ 'f4 L{ Completion of the followin&table may be waived by the Inspector of Wires. U Tr aa nsformers KVA € No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans No.a C1 ' No.of Luminalre Outlets No.of Hot Tubs Generators KVA de No.of Luminaires Swlmmin pool Above In- No.of Emergency Lighting g grnd. ❑ grnd. ❑ Battery Units `I 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 I`! No.of Ranges No.of Air Cond. Tons Total No.of Alerting Devices No.of Waste Disposers Totals: Pump Number_Tons_._.KW No.of Self-Contained Totals: " ' "'''"" Detection/Alertingrevices No.of Dishwashers Space/Area Heating KW Local 0 Cy000eil; n 0 ' No.of Dryers Heating Appliances KW Sece .00fm No. Devices or Equivalent 'No.of Water KW No.of No.of Data Wiring: ys Ballasts No.of Devices S vices or Equivalent No.Aydromaauge 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: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 1 BOND 0 OTHER 0 (Specify:) I certify,under the pains and pens?ties of perjury,that the information on this application is true and complete. FIRM NAME: �-�-- LIC.NO.: 3 c,-.A Licensee: \C c Signature J7.,r I CG<-Yl, LIC.NO.: D.�j3 (If applicable,enter"exempt"in tip license gamb�r erne.) ,5 '' T �— , I Address: " s r VL( ! f trJ,NAft'-,enA' 1 Bus.Tel.No.. d>� 'Per M.G.L.c.147,s.57-61,secy4ity work requires Department of Public Safety"S"License:AIL LieTe 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$