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Home My WebLink AboutBLDE-22-004189 Commonwealth of Official Use Only kf bilk Massachusetts Permit No. BLDE-22-004189 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/071 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:1/27/2022 City or Town of: YARMOUTH To the I ector of Wires: By this application the undersigned gives notice of his or her intention to perfom the electrical work describe n�.,ow. Location(Street&Number) 41 POWERS LN R (li /� Owner or Tenant SIMIlirvsziirnLB R Telephone No. I Owner's Address 2 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ropriate Box) Purpose of Building Utility Authorization N. Existing Service Amps Volts Overhead 0 Undgrd `eters New Service Amps Volts Overhead 0 Undgrd w yy��rs Number of Feeders and Ampacity 'tea Location and Nature of Proposed Electrical Work: Replacement HVAC /_O) __�� Completion of the followin i Spector o/'Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of ///�� Dial Trans 'ic" /Q� KVA No.of Luminaire Outlets No.of Hot Tubs Generatof..,A KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergent ightin // grad. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiatine 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/Aleriine Devices _ No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Sean C Rogan Licensee: Sean C Rogan Signature LIC.NO.: 20141 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 MELIX AVE,PLYMOUTH MA 023601280 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:1 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:S50.00 R E C J D JJAN 26202 I onimo ea of�a.6sac i • Official Use Only n _, 1+_ DING OEHAR] I ! 'q7 Pe t �t "' �- -.:.,,_-_. - 1 rout N o. - L '1 1 iii 7 _ ' ---- - - - --ap•• o� u a �crvice� s. -- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -.`�``�� 1Rev. U07] (leave blank) d DI:" I!'� .A T 1 i1■ [ t�n e-� r�r-.� . .�— — _ . ...� . ` viy<< , v rERrur[vi tL EU I KILAL 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 INFORMATIOA9 Date: /12C /2.2, City or Town of: B phis a YARVIOUTH To the Inspector of Wires: Y ` pplication the Trindersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 4 / Po rtis Lam,e Owner or Tenant idoba ft /4? Telephone p e Na. Owner's Address . Is this permit in conjunction with a building permit? Yes No _ (Check Appropriate Box) Purpose of Building A 'e//1/ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead E Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (Cpi' - ii vq, , Sri" Completion of thefollowing table may be waived by the Inspector of Wires No. of Recessed Luminaires No. of CeiL-Susp. (Paddle) Fans 1No. 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 mod- arnd. 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. Total Tons No• of Alerting Devices No. of Waste Disposers Heat Pump I Number `TonsH KW No. of Self-Contained ' Totals: - r Detection/Alerting Devices 1 Municipal No. of Dishwashers Space/Area Heating KW •Local Connection ❑ Other No. of Dryers Heating Appliances, Security Systems:* ' No. of Water No. of Devices or Equivalent Heaters KW No, of 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: 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: 1/2 JZ2. Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived bythe owner, no permit p p ❑. the licensee provides proof of liability insurance including "completedpto e performance of electrical work may issue unless undersigned certifies that such covera 's in force, and has exhibitedproof of operation" coverage or its substantial equivalent. The CHECK ONE: INSURANCE gO� same to the permit issuing office. ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete.. ` FIRM NAME: ,5,-C ' /� LIC. NO.: 2�� 1 Z...111 Licensee: �-e 46,04/ Signature (If applicable, ent "exempt" in the icense number line.) LIC. NO.: ..r/3�-�� I Address: J L' f€j%,t _,... �' ,ni Bus. Tel. No.: r'�u• 3( Jc� J ' Per M.G.L. C. 147, s. 57-61, securityAlt. Tel. No.: 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) Elowner El owner,s agent. 7 Owner/Agent Signature Telephone No. I PERMIT FEE: $ 1