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Home My WebLink AboutBLDE-22-004942 .M r Commonwealth of Official Use Only E. ►�' Massachusetts Permit No. BLDE-22-004942 �i 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:3/8/2022 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) 101 ROUTE 6A .,l `f Owner or Tenant TILLY SVEN Telephone No. Owner's Address OCONNOR BETSY,101 ROUTE 6A,YARMOUTH PORT,MA 02675-1709 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.oftMete"'s New Service Amps Volts Overhead 0 Undgrd 0 No.offtetds\ l/ / Number of Feeders and Ampacity /�,. Location and Nature of Proposed Electrical Work: Replacement furnace. 1 ] 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 1 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 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 Sims No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: ANDREW G THOMAS Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 ECHO LN,CHATHAM MA 02633 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) ❑owner 0 owner's agent. Owner/Agent Signature Telephone No. !PERMIT FEE:$50.00 \i —V7/ / (f®:LC 6/) w: /uie (_)lticial Use Only — __I t commonwealth. oai�achtt� Permit No. E--72- --Lk9 Cf 2----' awl epartment o 3ire Servicei -= /< Occupancy and Fee Checked -$/` BOARD OF FIRE PREVENTION REGULATIONS [Rev. 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: 3 ) 7,1 d d. City or Town of: '' f(hew 1 11 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) t 0 1 emit (0A Owner or Tenant M WOK Telephone No. (561)-157 666,3 Owner's Address l d 1 fk oVS-c G At Is this permit in conjunction with a building permit? Yes I No U (Check Appropriate Box) Purpose of Building Its I dt,V a,\ Utility Authorization No. _ ______ Existing Service Zo to Amps 1k / ago Volts Overhead,❑ Undgrd ❑ No. of Meters 1 New Service Amps / Volts Overhead l 1 Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Q,p I,urnaC� Completion of the following table may be waived by the Inspector of Wires. Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Tf Transformers KVA No. of l.uminaire Outlets No. of Hot Tubs Generators KVA Above In- No. of Emergency Lighting No. of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery' Units No. of Receptacle Outlets 1 No. of Oil Burners FIRE ALARMS No. of Zones No. of SwitchesNo. of Detection and I No. of Gas Burners r Initiating Devices Total No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat Pump Number Tons KW No. of Self-Contained No. of Waste Disposers Totals: Detection/Alerting Devices No. of Dishwashers Space/Area HeatingKW Local ❑ Municipal ❑ Other -i' p 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 Equivalent a Bathtubs No. of Motors Total HP Telecommunications Wiring: No. Hydromassage No. of Devices or Equivalent OTHER: 4.515. Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: oe (When required by municipal policy.) Work to Start: Mtcl '7 a a a 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. CIIECK ONE: INSURANCE El BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: "jtiDnci,i Fit CA= . t,k ( cv(Vi( .t.. I h C LIC. NO.: ICa _A Licensee: fibl il o ( 4( Signature LIC. NO.: � t W � (If applicable, enter "exempt" in the license number line.) — Bus. Tel. No.: l `6 l 7- 5 . .S 7 ) Address: 7 t Ct4 a Z g h c C I k i kk Is" (5.1(3) Alt. Tel. No.: *Per M.G.L. c. 147, s. 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) El owner ❑ owner's agent. Owner/Agent I PERMIT FEE: Signature Telephone No.