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Home My WebLink AboutBLDE-23-000420 Commonwealth of Official Use Only (fE: , Massachusetts Permit No. BLDE-23-000420 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:7/26/2022 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) 86 Old Hyannis Road, Yarmouth Owner or Tenant Tom Penderfast Telephone No. Owner's Address 86 OLD HYANNIS ROAD, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Install conduits for future hot tub&exterior kitchen. 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: Detection/Alertine 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 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: 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: JEFFREY T FOSS Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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 Ii\r 1f7f'7z iOARD CEIVED p, [Ll�of///aeeachr�atfe Official Use OnlyL �62U2Lo as PermitNo. nlyNG UtPA F FIREIMENTOccupancy and Fee Checked OF FIRE EVENTION REGULATIONS [Rev.I/07j (leave blank) U APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 5227 CM 12,00_ (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /J/J� /tJ .,\�` City or Town of: YARMOUTH To the Inspector of ires: By this application the undersigned giv notice of e e,G hisn or her intention to perfo the electrical rk described below. Location(Street&Number) r ) OM) �� d 1/, / tI Owner or Tenant A41 E �IJy //' �T Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. / Existing Service ' Amps It G/.?fc)Volts Overhead❑ UndgrOn No.of Meters / New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ,v/y� i Locati n d Nature of Proposed Elecrghtrical ork•. i l fV ,, � i ,� / Completion of thefollowing table may be waived by the Inspector of Wires. Q, No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 'total �/ Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4 No.of Luminaires Swimming Pool Above ❑ In- 0 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 Tota'`' No.of Ranges No.of Air Cond. Tone No.of Alerting Devices No.of Waste Deposers Heat Pump Number Tons KW No.of Self-Contained Totals: ........ ...... .............. ��- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municnnectipallou 0 Other No.of Dryers Heating Appliances KW Securitym No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters 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 ec 'al Work: •' (When required by municipal policy.) Work to Start: 7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE 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 BOND 0 OTHER 0 (Specify:) C6 /��I//��P �� CG r 7" ' I certify,under the pains and penalties of perjury,that the information on this app aE Lion is true and complete. FIRM NAME: _ LIC.NO.: �7�� Licensee: Signature LIC.NO.: *I L 1 (If applicable, nter"ese t rite i nsenu^�f r ine. ,',� ��'s 7t Bus.Tel.No.• .�• `/Q Address: •'J�3 DL1/ 'J / e 1V i �j j�le7.� t/�6�� Alt.TeL No.: 7/j1�/•--I/6 � *Per M.G.L.c.T47,s.57-61,security work requires De ent of Public Silty•'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:$