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Home My WebLink AboutBLDE-23-002973 Commonwealth of Official Use Only 11-i. P4) Massachusetts Permit No. BLDE-23-002973 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:11/30/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ol'his or her intention to perform the electrical work described below. Location(Street&Number) 17 CORPORATION RD Owner or Tenant STEVE BALANGER Telephone No. Owner's Address 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: Permit for final inspection of expired permit. (Permit#: E20-4896 3/5/20) 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 Tons Heat Pump Number _ Tons KW No.of Self-Contained No.of Waste Disposers Totals: 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: Shawn Micheal Ricard Signature LIC.NO.: 22895 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7748012921 Address:27 Baywood Drive, Orleans MA 02653 Alt.Tel.No.: 9788157031 *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: $100.00 .. RECEIVED •`16.. ig of/�! kazwite official Use Only ✓j 36 . s, NOV 30 202p2to ea[ csseac Permit No. Ei23 7_—Cr-7 nE o i.r Sartfics4 ILDING DEPARTME Occupancy and Fee Checked i :__BOARD-DEFIRL "REVENTION REGULATIONS Rev. 1/071 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: 11 i l � City or Town of: �;N:tau k 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) j 7 Cam; yi.rrefito.^, I2 Owner or Tenant r_)\t v P.?:>r+�;I b g,L Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ® No (Check Appropriate Box) f Purpose of Building CO.e r _e e ,,;A `tv,,..1.4 \. ,16 t t1 Utility Authorization No. Existing Service Amps / Volts Overhead [ Undgrd I I No.of Meters New Service (;cc Amps /,,)c, / �`li?. Volts Overhead E Undgrd R No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: Y,,ti, c- �1�'lil �j O V)ik(si„r , ' completion of the following tab/e may be waived by the Insjector of Wires. vi Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No. f Trano KVAsformers KVA IZZI No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.47 of Luminaires swimmingPool Above ❑ grnd. ❑ Bate EmergencyUnitsfighting grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 'No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin 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 Data Wiring: Heaters Signs Ballasts No.of Devices or E quivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail rf desired,or as required by the Inspector of Wires. Estimated Value 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 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: ,n r\t c..�c a t 1. f ,t �1 LIC.NO.: ;\v 'L 51, Licensee: ^��%, �,,,\ {d.\t e,,,.(4 Signature - LIC.NO.:L 14 C�S 1 (If applicable enter"exempt"in the license number line.) Bus.Tel.No.:101-7.74 41 I Address: /C )2,YJ:q l'l 4 (' '1,k•-4^j 1 ►\\N, Alt.Tel.No.:ci TS-2r.;-"in 4 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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. I PERMIT FEE:$