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Home My WebLink AboutBLDE-20-001166 or \'VP Commonwealth of Official Use Only tin 4111 Permit No. BLDE-20-001166 Massachusetts 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:9/3/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 58 ADAMS RD Owner or Tenant STROBL JANICE E Telephone No. Owner's Address 58 ADAMS RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Conversion of garage into living space. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 No.of Total Transformers KVA No.of Luminaire Outlets 6 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Batter/Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and 1 Initiating Devices No.of Ranges No.of Air Cond. 1 Total 2 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinu Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances 1 KW 1 Security Systems:* No.of Devices or Equivalent No.of Water 1 KW 1 No.of No.of Data Wiring: Heaters Siens 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 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: Bryant K Dundon Licensee: Bryant K Dundon Signature LIC.NO.: 53109 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:67 TAURUS DR, MASHPEE MA 026493458 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 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: $75.00 t -- -C- -4c3K-1-63.0X 6C1W443t4s 12EZWIRti> i v s u ) 1 1) G 4 i (> 00 0 4t Z(( 'NI tc /-/D.%i s ' ` J� .). Comrnotuvedg of Ma-isaehulSfts Official Use Onl r! 2eparinuusf o f.moire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Ov. 1/D7cy.and Fee Checked [Rev. 1/0 T) F- (leave blank) ,�.. - —.'z APPLICATION FOR=PERMIT TO PE f W PERFORM ELECTRICAL WORK � �' 2 I All work robe o performed in accordance with the Massachusetts Electrical Code C),527 CAR 12.00 (� LEASE PRINT IN INK OR TYPE Al L INFORMATION) Date: c....-,o Ci or /7 , 20l i o Town of: YARMOUTH To the Inspector of Wires: C t z this application the ltridersigned ties notic o his or her inter'ono perform the electrical work described below. o L cation(Street&Number) / 5 4...y‘ nG % ? ner or Tenant Telephone No. — _,.___--O ner's Address Is this permit in conjunctio with a buildingit? Yes ❑ No y� perm ❑ (Check Appropriate Boz) C� Purpose of Building i& --pf�...,-77t Utility Authorization No. q) Existing Service (d fg Amps (?C /2 o Volts Overhead Und i;Td❑ No.of Meters / New Service 7oc Amps feo /2 rig Volts Overhead Undgrd / ❑ No.of Meters Number of Feeders and Ampacity ('v 1 Location and Nature of Proposed r 1 J ropProposedElectrical Work 54 f c- !"/Fift !r0 C'r-/ /4-s•G/J rG - /11�U /I�e�� /!/>>1 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cm1.-Susp.(Paddle)Fans / No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ rn In- ❑ No.of Emergency Lighung - l:rnd. sd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No,of Switches . No.of Gas Burners No.of Detection and -� , Initiating_Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 1.. Connection ❑ Other No.of Dryers Heating Appliances / KW -Security Systems:* No.of Water No.of !"� No.of Devices or Equivalent Heaters Kn No.of Data Wiring: ��`'� Signs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER• No.of Devices or Equivalent ' Attach additional detail if desired or as requiredthe Inspector Estimated Value of Electrical Work .f 1Cc rj 4, by P of Wires. Work to Start: (When required by municipal policy.) V 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 0 BOND ❑ OTHER I cet•tify, under the ❑ (Specify:) p and penalties of 'ury,that the information on this application is true and complete. FIRM NAM • • �r----7 C I LIC.NO.: / f� Licensee: Signature (If applicable, er"exempt m the license number line.)`/ LIC.NO.: J. Address.: _ �' �� r �� us.Tel.No.:may /c y Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyAlt.TeL No.: � OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liabilit Lin.No. S required by law. By my signature below,I hereby waive this requirement I am the(check one ❑oow er D o n normally Owner/Agent ❑owner's a ent 11[ Signature Telephone No. •.• PERMIT FEE: $ r' --