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Home My WebLink AboutBLDE-23-002520 Commonwealth of Official Use Only 11 Massachusetts Permit No. BLDE-23-002520 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:11/8/2022 City or Town of: YARMOUTH T o 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) 96 PINE GROVE RD Owner or Tenant SAULT CHRIS Telephone No. Owner's Address SAULT AMY, 10 MICHELLES WAY, FRANKLIN, MA 02038 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 HVAC. 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 grad. grad. Battery Units No.of Receptacle Outlets 2 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. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other: 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 ❑ 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: Licensee: Adair Martins Signature LIC.NO.: 23369 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 Franklin Avenue, Hyannis MA 02601 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 q-ia, (gecvy _e 6., ,,,,. e>» �iti (cl ops CPAd ClCb ltico ( RLE VED NOV 0 2U12� ek Cowry �)//// ry-�,9 - Conunonwea(!h e j rriaesachirseatte Official Use Only BUILDING DE'•'-= " i/ I —7 ny: _i i-v:•.tl•a�� cx c-t ((�� Permit Nc Z� C��7<J e..,. 2oparinunt o/_Vim Jervicee 'Y BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 7 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:)1/0?f,)-)— • City or Town of; YARMOUTH To the Inspector of Wires: By this application the undersig ed fives notice of his or her intention to perform the electrical work described below. Location(Street&Number) j Ilk, Cp R i1 Owner or Tenant G,In i R-_i it ✓ Telephone No. "` - Owner's Address• y ��4 ai Is this permit in conjunction with a building permit? Yes ❑ No ,-�/ Ly (Check Appropriate Box) L. Purpose of Building V_F ,den, ) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd El No.of Meters '' g ' OmService Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (.f.'t'1-iI !'�/i c'o_ �l,i,ii 5t 5 Lie(;( 1-S C id'A P.u�P-f ge f'u co A-S: i O�✓f�S J y vv Completion ofthefo1lowingfable m be Ivied b_the Inspector of Wires. u� No.of Recessed Laminaires No.off 7 otal o No.of Ceti:Sosp.(Paddle)Fans Transformers KVA C-s No.of Luminaire Outlets No.of Hot Tubs Generators KVA -t No.of Luminaires - Swimming Pool Above ❑ In- No.of Emergency Lighting - grad. grnd. Battery Units �' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and I No.of Ranges fatal Initiating Devices a No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number[tons KW No.of Self-Contained Totah:I .`. "+""'- "' Detection/Alertin Devices No.of Dishwashers Space/Ares Heating KW Local❑Municipal No.of Dryers Heating Appliances KW Security Systems:* �� - No.of Water No.ofNo.of Devices or Equivalent Heaters KW' No.of Data Wiring: ' Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Estimated Value of E ec _ Attach additional detail if desired,or as required by the Inspector of Wires. trial Work: t2yr) (When required by munici Work to Start:') o �1 Rulie Y) .2 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E GE: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE[BOND 0 OTHER❑(Specify:) I certify,under the ins and r �)penalties ojpe J ary,that a Information on this application is true and complete. FIRM NAME. Licensce: Signature J_ _ n^ LIC.NO.: 3'- r '-;} -- (If PP/icabl,errs •erempt"in the i' a rum tine.) I rl`( '� LIC.NO Address. ,4 " c-1,-11,.U, �'IA,(r�-rl,'1,'S 1 •(r 02-6 1 Bus.Tel.No.• 1�3 Per M.G.L.c.147,s.57-61,security work requites Department Alt.of Public Safety"S"License: AIL Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. Bymysignature Owner/Agent below,I hereby waive this requirement. 1 am the(check one owner owner's a ant. Signature Telephone No. pPERMIT FEE:$ ,: ;� V