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Home My WebLink AboutBLDE-23-005603 .l I) Commonwealth of Official Use Only ��_ Massachusetts Permit No. BLDE-23-005603 ttit:;? 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:4/10/2023 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) 78 ACRES AVE Owner or Tenant BALCOM JOHN M Telephone No. Owner's Address BALCOM JEANNE L,2 AUTUMN AVE,AMHERST, MA 01002-3316 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: Septic pump &alarm. Completion of the foll wi A ? „b the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans ' ► Total ;,. dillir KVA No.of Luminaire Outlets No.of Hot Tubs Ge a I s KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of ►'!h 84p, grnd. grnd. Battery Units • No.of Receptacle Outlets No.of Oil Burners FIRE ALARM 6 , . es No.of Switches No.of Gas Burners No.of Detection and Initiating Devices40 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 1 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Siens No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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:) 70 _6 8 4 -6 7,99 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Tyler Mullen _ Signature LTC.NO.: 56358 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:80 Clover Lane,Stoughton MA 02072 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 lat / jL/� CD(Stkra. u� !Ji 4 S't 0 �i�� 1111 1 RECEIV2E.,n ; 4m�lO.ry oekrlbcO.a '.r L�>' r7t c7 �a Permit No. t 3 APR0 7-(_ ._ : 1J.par6n.al a�Jir.J.,vecYs Occupancy and Fee Checked ;' BOARD OF FIRE PREVENTION REGULATIONS [Rev.i/07) (tease blurb) BUILDING DEPAR •" -/ ' err. •• '- ICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed m accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: L 1 -(o- 1_;13 City or Town of: \JacMoli t1-. To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. a Lotion(Street&Number) �R AurCS All . West- t/Gr/•'tou'4.1.-‘ Owner or Tenant 5e(i.nvtf (.. (30,lCd tn., Telephone No. Owner's Address 'a At...k-u rvWt AO AM44ifS)- MR 010(;,2 Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building 'CGS;ZLt.s,G Utility Authorization No. Existing Service `6() Amps \7,0/Z`{u Volts Overhead Undgrd❑ No.of Meters 1._ NewService Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 6 co_i - S'Isl- . A(c.r-,vu GU 1 r;h J... t. kVil Completion of thefol(owing,table may be waived by the Inspector of Wirer. Total U No.of Recessed Luminaires No.of CeiL.S (Paddle)Fans No.orKVA N seep• Transformers KVA tl No.of Luminaire Outlets No.or Hot Tubs Generators KVA n Above In- No.of Emergency ghting No.of Luminaires Swimming Pool end. ❑ mid. ❑ Li Battery Units 1 No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na of Detection and F Initiating Devices II.' No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste 'Heat Pump Number Tons KW 'No.of Self-Contained Disposers Totals: Detection/Alertinil�Devices No.of Dishwashers Space/Area Heating KW Local ElMCouneuniciepal tion 0 Other i • No.of Dryers Heating Appliances KW Na of Devices or Equivalent No.of Water KW 'No.of No.of Data fig: Heaters Signs Ballasts No.of Devices or Equivalent Hydromasaage Bathtubs No.of Motors Total HP TcloNo.of Devices our Equivalent OTHER: Attach adn5tional detail(desired or as required by the hapector of Wirer. Estimated Value of Electrical Work: 1 fl) (When required by municipal policy.) Work to Start i'l^6-23 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® BOND 0 OTHER 0(Specify.) I cadfy,under the pains and penalties of pafoy,that the Information on this application is true and complete. FIRM NAME: 1 Nis{ ikAati" Li L. /Tliff ,E„ LIC.NO.: C(o S 6 '-(3 Licensee: T te.' /M.s.arm Signature -.,77'� LIC.NO.: (If applicable,ere'exempt"in the license'norther line.) Bus.TeL No.^7tl'(o S(o•(.2 S� Address: C.VA /✓te./n. 'S♦,. l'}c'&itt M� 02339 Alt.TeL No.: •Per MG.L c.147,a.57.61,security 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)0 owner ❑owner's agent_ Owner/Agent PERMIT FEE:S Signature Telephone No.