The URL can be used to link to this page

Home My WebLink AboutBLDE-23-002788 AMCommonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002788 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:11/18/2022 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 described below. Location(Street&Number) 20 HEMEON DR Owner or Tenant CLARK RANDY R Telephone No. Owner's Address 20 HEMEON DR, WEST YARMOUTH, MA 02673 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Water Heater 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 rnd. 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: J 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: Garry Thorpe Signature LIC.NO.: 57158 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 7742686102 Address: 5 Mcgee Street,West Yarmouth Ma 02673 Alt.Tel.No.: 7742686102 *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 tov(-z2 RECEIVED ... �,. « t 17�V 1 c ��o "al4///a.A./6 Official Use Only .�7 per/ :Y,..� li l� I �I ��ll Permit No. :-,2 3. a1,2' D p �- F. P Gronl al i,o Jervic.4 4ILBI ` if E EVENTIONREGULATIONS Occupancy and Fee Checked 'Roy.1/07] (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: Ii //J 4.,.;- City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned Ives notice of his or her intention to perform the electrical work descri d elow. Location(Street&Nt�ttber) �t I /{EMS nil �� DES/ Y/q//1/{U�l/ Owner or Tenant t\(D�,C21 s,4//y7 yYj-e____ i Telephone No..;cfS-2.3 V,()qv., Owner's Address C;eo-(.-e- Z-y WE s'i Z/� /i ,, ( Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service l r1,2 Amps Ie/C Volts Overhead Undgrd.- -' ❑ g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �U �E M E u Y y� Yt/ 4 Ch j�o ' Completion of the jollowing table may be waived by the Inspector of Wires. '`! No.of Recessed Lnminaires No,of Ceil:Sosp.(Paddle)FansNo.of 7 otal Transformers KVA '`t No.of Luminalre Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting grad. Rind. ❑ Battery Units No.of Receptacle Outlets No.of OB 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. Tons No.of Alerting Devices No.of Waste Disposers Tleat Pump Number Tons„ KW No.of Self-Contained Totals: ....... ....._._. Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local ElMunicnnectioipal n ❑Other Co No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.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: 4L 5-0 (When required by municipal policy.) Work to Start:////7 t 1Ins{tcctions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE �GE: 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 cerrlfy,under the pains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: / _ LIC.NO.:,c... /51R Licensee: , Q�/ f ._) E Signature ' LIC.NO.: Of applicable,enter"esem�in theicens� �' Bus.Tel.No.•7�7t_.2 ,(J,2, Address:, /tip I I7-2t,� Alt.Tel.No.: "Per M.G.L.c.147,s57-61,security work require 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$