HomeMy WebLinkAboutBLDE-23-006151)une 20, 2024
Ken Ettiot, ElectricaI lnspector
Town of Yarmouth
1 146 Rt. 28
South Yarmouth, MA 02664
Re: 286 Otd Main Street; So. Yarmouth
Dear Ken,
Ptease be advised that Payne Etectricat is no tonger the Etectricat contractor tor this
project. Jack Griff in has taken over the proiect and witt, or has, submit the paperwork necessary for
this transition.
lf you have any questions or concerns ptease do not hesitate to contact our office.
George Davis, President
George Davis lnc.
RECEIvED
JUN 2 0 202rr
BUILDING DLPARl MENTlly
--
DESIGN . BUILD. RENOVATE
508'19.1 5J60 lA\ C{roqlcD.rviilnc.conr] l NORTH MAIN STREET, SOUTI-I YARMOUTH, MASSACHUSETTS 02(16'1 508 l9'1-0u12
Thank you,
I EORGE
Commonwealth of
Massachusetts
BOARD OF FIRE PREVENTION RECULATIONS
Oflicial Use Only
Permir No. BLDE-23-00615.1
Occupancy and Fee Checked
[Rev.l /07]
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to bc pcrfomrcd in accordancc with the Massachuscns Elcctrical Codc (MEC). 517 CMR 11.00
(PLEASE PRTNT tN tNK oR TvPE ALL INFokuATtoN) Dzte:51712023
City or lown of: YARMOUTH
By this applicarion rhc undcrsigDcd givcs nolicc ofhis or hcr intcntion lo pcrfomr thc clccrical work describcd bclow
Location (Strcet & Numlrcr) 286 OLD l\4AlN ST
To the lnspector of Wires
Owncr or Tcnrnt WELCH ANNE E TR Tclcphone No,
Owner's Address ANNE E WELCH REVOCABLE TRUST, 300 SUMMER ST NO 27, BOSTON, MA02210
Is this permit in conjunction rvith e building pcrmil?
Purpose of Euilding
Exisling Servicc _ Amps
Ncrv Servic. _ Amps
Number of Fecders and Ampecity
_ \'olts
volls
Overhead E
Overhead D
Yes tr No E (Chcck Appropriate Box)
Utilitv Authorization No.
Undgrd O
Undgrd O
No. of Meters
No- of Meters
Location and Narurc of Proposed Electrical worki Remodel residence & ufer grounding with service
Estimated Value of Electrical Work
Completion ofthe following table nmv be waived by ector of ll/ires
Attach udditional detail ifdesircd, or as rcquircd by lhe Inspeclot of Wirct
(When required by municipal policy.)
Work to start Inspection to be rcqucsted in accordance with MEC Rulc 10. and upon completion
INSURANCE COVERAGE: Unless waived by the owner. no permit for the performance ofelectrical work may issue uoless the licensee provides
proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned ccrtifies that such coverage
is in force. and has exhibited proofofsame to the permit issuing oflice.
CHECKONE: INSURANCE tr BOND tr OTHER tr (Speciff:)
I cenify, under rle pains and penalties ofperjury,lhat thc irtonndlion oh this opplicatioh is fiue and con plete.
FIRMNAME: TYLER W PAYNE
Licensee: Tyler W Payne Signaturr LIC. NO.: 22091
(l/applruthb. ! kt "lrtDryt" i tlrc li.ense ntnber li e )
Address: 5 JANS PATH. HARWICH MA 026452458
Bus. Tcl. No.:
Alt. Tcl- No-:
*Per M.G. L. c. l4?, s. 57-61 , security work requires Deparlment of Public Safcty "S" License:
OWNER'S INSURANCE WAIVER: I am aware that the License tloes not hove the liability insurance coverage normally required by law. But my
signature below, I hereby waive this requirement. I am the (check one) E owner E owner's agent.
Owncr/Agcnt
Signature Telephonc No PERMIT FEE: $230.00
Vfis?- Qu^xvo d, A e-
Cv- Wew_;ft^/,+ €__
\o. of Rcccssrd LuDrinaires No. of TolelKVA
No. of Luminairc Outlots No. of Hot Tubs (;encra(ors KvA
No. {,f Lurrin:rircs Swimming Pool tr trgrnd.In-grnd.No. of Emergency LightingBrtterv lJnits
No. of Rrccptacle Oullets No. of Oil Burnrrs }.IRT] AI,ARMS No. of Zoncs
:-o. of Switchcs No. of Gas Burncrs No. of Detection ,ndlnitirtino Devicer
No. of Air Cond.Totel
Tonr No. of Alcrting Devices
Nunrber Tons K\\.\_o. of Waste Disposers Hsrt Punlp No. of Self-Contained
Detection/Alertitrs Devices
Spacc/Arcr Hesting KW Locrl EI O otherMunicip.l
Connection
Heating Appliancrs KWNo. of Dr)ers Sccurity Systemsi*
No. of Devices or [ouivaleDt
KNNo. oI\\'atcr
Heaters
No. of BallastsNo, of
SisDs
Data Wiringi
No, of Devices or Eouivalent
Total HPNo. Hydromlssagc Bethtubs Tclcconrmunications \l iring:
No. of Dcvices or Eouivalent
01'HDR:
-I-
\o. of Ccil.-Susp.(Prddle) Fens
.\.-o. of Rangcs
l-o. of Dishrashers
&-\Co m m o nwea lth of Massa c h u setts
Department of Firc Services
BOARD OF FIRE PREVENTION REGULATIONS
Official t.,se Only
Occupancy and Fbe Checked
t
av..o
'c(t-/e<soI')-%
)r UJJrurJ,{,
_(,<-Y
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.ir)'c
R.ev. 9/05 |(leavc bldnk)
APPLICATION FOR PERMIT TO PE HFORM ELECTRICAL WORKAll work to be perfornred in accordance rvith lhe Msssach I Codc (MEC ..527 CMR t2.00
(PLEASE PR|NT IN INK ORryPE ALL I.VFORMATI 0ti)
usctts AccI.ica
Date:o o Ao)-3
City or Town of:
By this applicalion thc undersi below,
L,ocation(Street&Number) J IOwner or Tenant
Owner's Addrcss
Telephone No.
Is this permit in conjunction with a building permit? yes No (Check Appropriate Box)
Purpose of Building Utilifi' Authorization No.
Exlstlng Service _ Amps / Volts No. of Meters
No, of MetersNew Service _ Amps _ / Volts
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical l{ork:
c table be v,aived the Whes
Estimated Value EI trical Work:
Auctch dddiriotnl detail ifdesired, or as required by the Inspector oJlVires(Wnon required by municipal policy.)
Work to Sta[:f Inspections to b0 rcqucstcd in ac0ordance rryith MECI Rr.tle 10, and upon cornpletion.
INSURANCE
rhc liocnsee pro
RAGE: ljnless rvaived by the os,ncr, xr per.mit for the pcrformancc ol electricnl tvork may issuo unloss
vidcs proof of Iiability insr.rmnce including "completed operation" coverage or its substantial equivalent, Thg
Overhead f, Undgrd
Overhead ! Undgrd
undersigned certifies that such coverage is in force, and has cxhibitcd proof of same to tho pormit issuing offica,
CHECK ONE: INSURANCE M BOND ! orHriR ! (specify:)
Slves n0 ce0 h s0I er intenli0n to
To the In.spector of Wires:
pefom the clecrlical work dsscri
I car4fil *ndor rha tnd penalties of perjrry, that ll* irforo,.ttiot, or. this applicatiort is tnre aud. complete.
FIRM NAME:l,tc. No,:51074 . B
Licensee: TY !NE Signature LIC, NO.
(t
Address;
*Sscurity
required by larv. By my signature belolv,l hereby waivc this requitement. I am thg (check o
Bus. Tel. No.
to\o l Alt. Tel. No,
System Contractor Liconso required for this "'ork; if ble, enter the license number heretlca
OWNER'S INSURANCE YIAIYER: I am awalo Lhat lhc Lioonsoc r/ocs not lr,ave rhe Iiahility insu:'anae Goycratc normall
PERMIT FEE: $
No, of Recessed Luminaires No, ofCeil,.Susp, (Paddle) Fans TrNo, of Tolaf-
KYA
No. of Luminaire Outlets KVAGenerators
No. of Luminaires Swimmingpoot f*T' n In.srnd. u
No, of Hot Tubs
NO. OI Emergency Llghtrng
Batter.y Units
No, of Rec€ptacle Outlets No. of Oil Bulners FIRE ALARMS No, of Zones
No, of Gas BrrrnersNo. of Swltches
No. of Ranges No, of Alr Cond,
,I
ToEt-
ons
No, of Detection andInitiating DeYices
No. of Alerting Dcvices
No, of Waste Dlsposerc TIEET PUMD
Totald:
um 0ns No. of S€lf-Contsined
Delgction/Ale{!ry Devlqes
No. of Dishwashers Space/Area Heatirg KW L*dn f#i,t[tl I oher
No. of Dryers Heating Appliances KW valent0r
KWNo. of l{ater
H€aters
No, of
- Qlgns
No, of
Ballasts Data Wiring:
No. of Devices or Equivalent
No, Hydromassage Bathtubs e
YA. of Devices or E
mmun onsNo. of Motors Total HP
OTHERT
Owner/Agent
Sisnature Telephone No._
olvnet'
v
t.
PermitNoIr-T -6( 9(
It !Y