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Home My WebLink AboutBLDE-23-004832 ;_ _ _ Commonwealth of Official Use Only/tk L.A11 Massachusetts Permit No. BLDE-23-004832 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:3/2/2023 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) 45 CARRIAGE LN Owner or Tenant DEAN CHARLES A TRS Telephone No. Owner's Address DEAN SUSAN J TRS,45 CARRIAGE LANE,YARMOUTH PORT 026750000 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: wire in 18kw generator&install flagpole on timer(508-776-7744) 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 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 0 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: HENRY LARKOWSKI Licensee: Henry Larkowski Signature LIC.NO.: 26990 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:91 HOKUM ROCK RD,PO BOX 267,DENNIS MA 026380267 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:$50.00 5 ( & (1,3 t f4-3 I- (rytw 1—o Cc.A6 po a L r OvtA426.s� s 1-002-9' 3(z 4/z3 RECEIVED MAR 02 2013�puncarsantalth of a � l� Official Use Only _1,--`—' ._ 'DING DEPARTM ,T ��77� Permit No. ----_, .....;-_---,-,---,ii... -Lie arfinant of 7ire Services 31- " — P Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS v. 1/07] 'leave blank APPLICATION FOR-PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 527 CMR 1 Da (PLEASE PRINT INWK OR TYPE ALL INFORMATION) Date: ;/ 2 C City or Town of: YARMOUTH To the Inspector of Wir By this application the undersigned elves notice of his or her intentionn to perform the electrical work described below. Location (Street&Number) 4 � / ,/ +/h il--- Owner or Tenant S L11� == ,( f Telephone No. Owner's Address �S A—Al Lti Is this permit in conjunction - h,a building permit? Yes E No''g... (Check Appropriate Box) Purpose of Building J O ill J C 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 / �r ,f,, ` l Location and Nature of Proposed Electrical Work: H -• f�/<(C c a c _hiS i --ii--1—( f L. (;.-/)L-1 _ L Completion of thefollowinEtable may be waived by the Inspector of Wires, addle Fans No.of Total No.of Recessed Luminaires No.of Cei1.-Sasp,(Paddle) Transformers KVA No. of Luminaire Outlets No.of Hot Tubs GeneratorsA Above In- No.of Emergency Lighting No. of Luminaires Swimming Pool Qrnd. ❑ Qrnd_ ❑ Battery Units 1 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 Z No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number 1Tons KW No.of Self-Contained Totals: Detection/Alerting Devices i No.of Dishwashers Space/Area Heating KW Local Munic ❑ Connectiipaoln 0 e'er No.of Dryers Heating Appliances KW Security Systems:* ry No of Devices or Equivalent ¢' No.of Water No.of No.of Data Wiring: Heaters KW No. Ballasts Na of Devices or Equivalent No. H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g Na of Devices or Equivalent * OTHER: �p Attach additional detail if desired;or as required by the Inspector of Wires. ii Estimated Value of E txical Worl ib (When required by municipal policy.) Work to Start: 2 • L.-. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 BOND ❑ OTHER ❑ (Specify:) c L (( c, IcL Ar s CL ; /23 I certify, under the pains and penalties of perjury,that the information on this agile'areOn is true and complete. 'II l FIRM NAM .• LIC_NO.: Licensee: j Si naturr-/ LIC.NO.: (ifapplica l entor-1"&prempty in the license numb e.) Bus.Tel.No.: Address: jl 0-6/ ?(,1)'� -61./.t)i 14 C) 3 Alt.Tel.No.: j *Per M.G.L. c. 147,s.57-61,security work requires Department o Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent. Owner/Agent 1 of Signature Telephone No. 1 PERMIT FEE: $ r .)91 sinM