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HomeMy WebLinkAboutBLDE-23-005570 Commonwealth of Official Use Only
it Massachusetts Permit No. BLDE-23-005570
......' 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:4/6/2023
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) 44 STUDLEY RD
Owner or Tenant MORGAN RICHARD W TRS Telephone No.
Owner's Address MORGAN NANCY A, 24 EMBASSY LN,YARMOUTH PORT, MA 02675-1521
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: Four zone mini split system.
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
Initiatine Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump , Number Tons KW No.of Self-Contained
Totals: 1 Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 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:
Licensee: Jon T Moreau Signature LIC.NO.: 22967
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:9 Redberry lane, MARSTONS MILLS Ma 02648 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
lfommonwaa�o`7r/aaeac�iw.tfe eOffficciial Usese Only
c� c7 Permit No. ASS /1)
2spartmant o`_ r•_>crvicse
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)
S 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: 3/31 l2023
City or Town of: Yarmntlth To the Inspector of Wires:
B y this application the undersigned given notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 44 Studley Rd
Owner or Tenant Bob Ducharme Telephone No.
^` Owner's Address 44 Studley Rd W Yarmouth MA 02673
v Is this permit in conjunction with a building permit? Yes ❑ No El (Cheek Appropriate Boa)
Si.) Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead❑ Uodgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Uudgrd El No.of Meters
di Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Electrical Connections For 4 Zone Mini Split
Completion of the following table may be waived by she Inspector of Wires.
V.lb No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tr.
of TransformersTotal
KVA
CINo.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In. No.01 Emergency Lighting
No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
t No.of Detection and
Zr. No.of Switches No.of Gas Burners Initiating Devices
Total t
IU No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
Heat Pump Number Tons KW 'No.of Self-Contained
No.of Waste Disposers
Totals: '[ ..............._...,..__..___....___. Detection/Alertip Devices
nic
No.of Dishwashers Space/Area Heating KW Local 0 C Mounnectionipal ❑other
No.of Dryers Heating Appliances KW SecNo Systems:*
of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
Heaters KW Signs Ballasts No.of Devices or Equivalent
ications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP Tetecommun No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 1500.00 (When required by municipal policy.)
Work to Start:4/3/2023 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 a BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Coastal Mechanical LIC.No.: 8082 Al
Licensee: ,Inn Mnrpatl Signature Cfri, aopzi L1C.NO.: 22gB7-A
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No:508-737-8747
Address: 21 L Fruean Ave S.Yarmouth MA 02664 AIL TeLNo.:508-326-A699
'Per M.G.L.c.147,s.57-6t,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)0 owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$75.00