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Home My WebLink AboutBLDE-23-003827 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-003827 �—' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:1/13/2023 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 bel y A i . , L Location(Street&Number) 388 NORTH MAIN ST 1V t� Owner or Tenant BENOIT MARY JANE Telephone No. Owner's Address 154 WINTER ST,HANOVER,MA 02339 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Miscellaneous work per attached. 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 god! grnd. Battery Units No.of Receptacle Outlets 5 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 Ions 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,er 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: STANLEY D ANDREWS Licensee: Stanley D Andrews Signature LIC.NO.: 15248 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:201 HEAD OF THE BAY RD,BUZZARDS BAY MA 025325640 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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$250.00 aureo_ tf(i( l .'' /�on��rwnwta[tk`, o`�1'lae6ac Official Use Only lr E I. ':I): •, c� Permit No. 3 ge 2 2eparinwni ol.7iee Sartoked Occupancy and Fee Checked ti BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) It 1. ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ci All work to be performed in accordant with the Massachusetts Electrical Code(M C),527 CMR 12.00 U (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /! ' 3 I 3 City or Town of: YA.r—w►.o,k i, To the Inspector of Wires: 19. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Locadon(Street&Number) 3 S 5' s /VJ A.I r. S/- Owner or Tenant ft'l_'ic,L�II p •tvtP i 4- Telephone No. ti Owner's Address 3( 9.41,lph. 1c.ULecl- `j- 5_ wtir/fr+e.-4'-I 1 thL t /1' J Is this permit in conjunction with a building permit? Yes L^f No ❑ (Check Appropriate Box) Purpose of Buildings I(,`v'- Utility Authorization No. Existing Service l00 Amps I X2i ;2 I/(f Volts Overhead 'Q Undgrd❑ No.of Meters SI New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters !Ni� Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work:ge ' kci I C•f'v��y ri A Act S v !J k P'—ClS i r► 3e4 S t-e 1 ,efta.�f 2rok-t` c 1.1-le ki i K L:v 'Zvi / FPO AA' 'mac/ V) Completion of the followingjable may be waived by the Inspector of Wires. kb No.of Recessed Luminaires No.of Cdl.-Susp.(Paddle)Fans Transformers No.of Total KVA C't No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- lVo.of Emergency Lighting d No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 5 No.of Oil Burners FIRE ALARMS No.of Zones of Z No.of Switches No.of Gas Burners No. InitGttingon Dete and IntC Devices 11.1 No.of Ranges No.of Air Cond. Taos No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained ' Totals: ............................ Detection/Alertinp�Devices Munici No.of Dishwashers Space/Area Heating KW Local 0 Connection ❑ Other No.of DryersHeating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or aivalent drontass a Bathtubs No.of Motors Total HP Telecommunications y atg No.of Devices or Equty �No.Hnt OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Ellictrical Work: (When required by municipal policy.) Work to Start: 1 110 .53 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 RI BOND 0 OTHER 0 (Specify:) I certify,under th pains and penalties of perjury,that the information on this application is trite and complete. FIRM NAME: v1;'2-4(I5 ea y 1 ivr-h 'C- LIC.NO.: /5- 4 >I Licensee:S r.us S Signature74 ._ LIC.NO.: Of applicable,enter 'exempt"in the license number line.) Bus.Tel.No.:ATtX-76-q—;/"Address: 401 Hr•-' el- �-1.-t "gel �t/Z7-�1t-y Ot'�•4'1�3 2 Alt.Tel.No.:.Tvrir-eve-iv 77 *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)0 owner 0 owner's agent. Owner/Agent PERMIT FEE: S Signature Telephone No.