HomeMy WebLinkAboutBLDE-23-15595 Commonwealth of Official Use Only
A. , � Massachusetts Permit No. BLDE 23-00344/ � /
i��'s� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Ch 15'7
[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:12/21/2022
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) 41 UNCLE ROBERTS RD
Owner or Tenant SCHEUCH RICHARD TRS Telephone No.
Owner's Address YOUNG JOHN R TRS, 80 LOEFFLER RD G522/523, BLOOMFIELD, CT 06002 __`_ J
Is this permit in conjunction with a building permit? Yes 0 No 0 eck Appropriate B ) �J 074 L
Purpose of Building Utility Authorizat' n No. 11462383 / vt 4ei 1
Existing Service 320 Amps Volts Overhead 0 Undgrd 0 No.of Mete
New Service Amps Volts Overhead 0 Undgrd No.of Meter/'
s
Number of Feeders and Ampacity _
Location and Nature of Proposed Electrical Work: New residence and 320A service
Completion of the.following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 50 No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets 20 No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- 0 No.of Emergency Lighting
grnd. grnd. Batter/Units
No.of Receptacle Outlets 60 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 60 No.of Gas Burners 1 No.of Detection and
Initiating Devices
No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump __Number _ Tons KW No.of Self-Contained
Totals: 3 13 Detection/Alerting Devices
No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal ❑ Other:
Connection
No.of Dryers 1 Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water 1 KW No.of No.of Ballasts Data Wiring:
Heaters Signs 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: 01/15/2023 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: Jon T Moreau Signature LIC.NO.: 22967
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 9 Redberry lane, MARSTONS MILLS Ma 02648 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: $245.00
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