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Home My WebLink AboutBLDE-22-005904 Commonwealth of Official Use Only Permit No. BLDE-22-005904 -i . , Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:4/14/2022 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) 135 SOUTH SHORE DR UNIT S Q Owner or Tenant CYNTHIE ANN WOLF,TRUSTEE Tele j Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ •ya� ! , r' tg'ox) Purpose of Building Utility Authorization No. A Existing Service Amps Volts Overhead 0 Undgrd ❑ -vr1'lm' j.: New Service Amps Volts Overhead 0 Undgrd ❑ •t• • `` Number of Feeders and Ampacity o Location and Nature of Proposed Electrical Work: MOVE 2-COUNTER TOP RECEPTACLE UP FOR BACK S' ' ' H . SOME LIGHTS AND SWITCHES Completion of the following tabs ely be w,•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 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. Totalo No.of Alerting Devices 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 ❑ 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: John R Hassay Licensee: John R Hassay Signature LIC.NO.: 38186 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:28 THAYER ST,SOUTH DENNIS MA 026603717 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 RECEIVED "c APR 14 2022 —.Ed. //o< � /aseaehusatls Official Use Only ..`:"" q Permit No. '"'p?rJ?.?-55aC./ y: �;�,,'s I NGUEPARTME •4artmanl°Pi"-�,wi'�° "" PREVENTION 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 Electrical Code(M)rC),527 CMRy 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:✓( / ( I { 'ZU 2'2_ City or Town of: YARMOUTH To the Inspector of Wire.: By this application the undersigned gives notice of his nr her intention to perform the electrical work described below. Location(Street&Number) j 3 t `Jv.�'� w�, D,-, e t()A i,t q (�\ (/'� � /J Owner or TenantC, tt-[-C,r s �N K �(,�.1 r' cat_. r %/'�5 � Telephone No. Owner's Address 13 t_7 -2 2-c)J 22 Is this permit in conjunction with a building permit? Yes F No ❑ (Check Appropriate Box) Purpose of Building C'o4"t,e_ 1),,,02-II;.&y/ ,50,,,Yi 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: how C 14v.0 Co..vtfer/ o et'S v v c ��4 L (IA(_kes .a- ne,.t. Ic+ckS®1isdi1 Glicc,lf-e ' i.e5.4 ((.5•kf-S avid Sw1- (.pa I Completion ofthefol(owing table may be waived by the Inspector of Wires. (! No.of Recessed LuminairesNo.of Cell:Sasp.(Paddle)Fans No. Total ^ Transformers KVA C.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA c., h- 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 INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. T nsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number['�'nos KW No.of Self-Contained Totals:l.. _.....I ......_._.._.1........ ........... 11 Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipa L0�0 Conoectlou O fit"' No.of Dryers Heating Appliances KW Security Systems:* No.No.of Water KW, Heaters Signs Ballasts No.of No.of Data Wiringvices or Equivalent 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 Valu 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 VERAG : Unless waived by the owner,no pemut 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 covers e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE / OND 0 OTHER (Specify:) I certify,under the pains and amities of perjury,that the Information net this application is true and complete. FIRM NAME: LIC.NO.: Licensee tti S Signam Of applicable,enter"exempt"in the i nse number line.) LIC.NO.:3 a(��E. Address: Bus.Tel.No.•Co 2 2 l-o g c[9 'Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety S"License: Alt.Tel.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)[]owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$