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Home My WebLink AboutBLDE-23-003754 Commonwealth of Official Use Only �E` Massachusetts �■�, Permit No. BLDE-23-003754 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:1/10/2023 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) 147 MAYFLOWER TERR Owner or Tenant TALLMAN BRADFORD L JR Telephone No. Owner's Address TALLMAN ANNE S, 147 MAYFLOWER TER, SOUTH YARMOUTH, MA 02664-1120 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Receptacle for fire place insert. 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 1 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. 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 ❑ 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Michael D Hollister Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD, S YARMOUTH MA 026641017 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 t kt / z3 Ag 1N31/11JNVd30 ONI011l8 RECEIVED EZOZ 01 NVf 1. att� yyyy��JAN 10 2023 i o •maestri of tt/aeaachiasdlr Official22 Use Only7 �;. _ 13 D 3 LD GDEPARTMENT PermitNo. ✓—J/ �Iyl '4-' I• - 4 arimad odes-�iraiur .) I :i' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) n, ,11 W. d APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code M )52 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: / /o/2 3 % O City or Town of: YARMOUTH To the Inspector of Wires: \J By this application the undersigned gives notice of his or her intention to perform the electrical work described below. _ ,k-C Location(Street&Number) /./7 �fry/`l,�v.y IC �e,-7e.(Z(�-G�- `� Owner or Tenant 1N IV#../ IA L L 114 11-7t Telephone No. iH ZI Z.S 39.-1 T7O Q Owner's Address t Is s permitn conjuoc on with a building permit? Yes ❑ No� this i ❑ (Check Appropriate Box) Purpose of Building . 5 I c)lyy✓C 6 Utility Authorization No. N Existing Service//Z/ Amps / Volts Overhead❑ Uodgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty fS—Ai'i/(7 ?v U A- f Zb ?G t b ),4,/.c g r Location and Nature of Proposed Electrical Work: pg/, 'qN.cL u,tcm �� . pi Du?S i m r_14e ern„uC.Y �a V v c TEt) ]Ta )o T - /N 7A5 .— ' Completion of the folowingble may be waived by the inspector of Wires. It: No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Fans No.of 'total _Transformers KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA •t; No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting _and. prod. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of GasBurners No.Initiating Devices and 1' No,of Ranges No.of Air Cond. To No.of Alerting Devices V No.of Waste Disposers Heat Pump Number Tons_,. KW No.of Self-Contained Totals: ............... ��''�� DeteMion/Alertln�Devlcea No.of DishwashersMunicipal Space/Area Heating KW Local Conner ion ' 't No.of Dryers Heating Appliances KW Security Systems:" No.of Water No,of No.of No.of Devices or Equivalent I`0 Heaters KW Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Rydromaasage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: _ Attach additional detail ifdestred.or as required by the Inspector of Wires. Estimated Value of lec cal Work: 9 0 (When required by municipal policy.) Work to Start: r Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE G : Unless waived by the owner,no permit for the performance of electrical work may issue unless J the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The IL undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. LICHECK ONE: INSURANCE ia BOND 0 OTHER❑ (Specify:) I certify,under the pains and penalties ofpei*uy,that‘the information on th r application is true and complete.FIRM NAME: J 1"YILL.,C% a 1? ✓h L Y.i-�-L 1 i J 1J Licensee: Ih -<? G LIC.NO.:/D d 1l Of applicable, l"esem t"in the license number line.)q Signature J LIC.NO.: J Addren: c/� 3F��,, I(r� Bus.Tel,No.: > _ i�� •Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Lie.No.a OWNER'S INSURANCE WAIVER: 1 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 ent. Owner/Agent • Signature Telephone No._�_ PERMIT FEE:$ 1