HomeMy WebLinkAboutBLDE-22-005337 ,. Commonwealth of Official Use Only
I— \ Massachusetts Permit No. BLDE-22-005337
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:3/24/2022
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) 41 STRATFORD LN
Owner or Tenant HAGGERTY WILLIAM W Telephone No.
Owner's Address HAGGERTY CHRISTINE J, 41 STRATFORD LN,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropri. :ox)
Purpose of Building Utility Authorization No. O
Existing Service Amps Volts Overhead 0 Undgrd 0 '1 et
tp
New Service Amps Volts Overhead 0 Undgrd 0 k,'�.o ,t •t
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install 4 zone split system. �
).44)),
Completion of the following table may be wa - .A Ins. o ires.
No.of Recessed L Luminaires No.of ot�
u es No.of Ceil.-Susp.(Paddle)Fans Vi
Transformers (A
No.of Luminaire Outlets No.of Hot Tubs Generators
441
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
Initiating Devices
No.of Ranges No.of Air Cond. 4 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 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 ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: ANDREW M LEVESQUE
Licensee: Andrew M Levesque Signature LIC.NO.: 17318
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:461 LOWER COUNTY RD, HARWICH PORT MA 026461831 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
Com mo nwealth.of Maddacluadel ld
Official Use Only
_—__1=-Mi=ft Permit No. �,�_5'37,-=�1_ a eeParlmenl o ire�eraiced
E _'1__e
Occupancy and Fee Checked
'� =—e BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07]
'^'-r.os (leave blank)
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: 3/21/2022
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) 41 Stratford Lane
Owner or Tenant Haggerty Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes n No ❑ (Check Appropriate Box)
Purpose of Building residential 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: wiring for 4 zone Fujitsu System
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf TVA
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
of
No.of Switches No.of Gas Burners No.Initiatinnggon Dete and
In Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection
No.of Dryers Heating Appliances KW 'Security Systems:*
tY No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications 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 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 N BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjwy,that the information on this application is true and complete.
FIRM NAME: Harwich Port Heating & Cooling, LLC LIC.NO. 593 Al
Licensee: Andrew Levesque Signature ,/,- LIC.NO.: 17318A
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:5B8-432-39Sg—
Address: 461 Lower County Rd, Harwich Port, MA 02n4n Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of 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 PERMIT FEE:$ 50
Signature Telephone No.
** Please fax a copy back to us at 508-430-6075 **
or e-mail to: kecia(a�hphcllc.com