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Home My WebLink AboutBLDE-23-002130 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002130 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1Rev.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:10/20/2022 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 desc ibbeed w. Location(Street&Number) 81 NEPTUNE LN � � —,1/O Owner or Tenant YOUNG SIDNEY H Telephone No. Owner's Address YOUNG FLORENCE G, 21 BELMORE RD, NATICK, MA 01760-3313 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: Lights in kitchen&living room. 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 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 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 ❑ 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: THOMAS P SULLIVAN Licensee: Thomas P Sullivan Signature LIC.NO.: 18182 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 WAQUOIT RD, COTUIT MA 026353517 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: $75.00 r.otjat,/ (c12e(-7. 1 ��' ` /(6 3 J iLiOCT 2 0 2022 a/ Co,hm9nwaa[th of rt/aeeachwaNe Officialfi Use Only rr�r Y: r ;,;- ,. .ryry,, cc-7/ Permit No. ('j 3-0 5' ■.:.:5,_._-'__._... ,CJ taunt al giro-ccervices 'q 1,4, . I Occupancy and Fee Checked S BOARD OF FIRE PREVENTION REGULATIONS [Rev.I/O?] (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: !t)—Z& Z & City or Town of: C YARMOUTH To `-_` By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 1v\ Location(Street&Number) / JY•,o rp km/F Owner or Tenant l 7 � � Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes No ❑ (Check Appropriate Box) v Purpose of Building • 'P S I aC - •y_, -i?.`1 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters r� Number of Feeders and Ampacity Locationti and Nature of Proposed Electrical Work: _ \�� S I i\ �) I' ld IN)-'4 I i n� eC Gil t� I�E C(Paddleompletion ofdrefollowingtable m be waived by the Inspector of Wires. Q., No.of Recessed Luminaires No.of CeB:Sasp. )Faos No.of Total Transformers KVA L No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ in- No.of Emergency Lighting crud. Qrod. ❑ 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. Tool No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW "cal Municip ❑Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:• No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Signs Ballasts Data Wiring: 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: t ) (When required by municipal policy.) Work to Start:/C�.21/'72 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 TBOND ❑ OTHER❑ (Specify:) I certify,under the1 and penalties of perjury,that the Information o application is true and complete. FIRM NAME: (e)I//( 3(i/)l t/,.�t] (/c C 4 n LIC.NO.: /t /�, Licensee: ,c,y1're,oa Z.,(...-2 Signature 't��lc-v�Z� 9�f� LIC.NO.: (lfapplicable, ter"exempt"in he license number line. Bus.Tel.No.. Address: // (,//%_ la CO Per M.G.L.c.147,s.57-61 security work requires Department of Public Safety"S"License: Alt.L c.No. OWNER'S INSURANCE WAIVER: i am aware that the Licensee does riot have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent Signature Telephone No. 1 PERMIT FEE:$