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Home My WebLink AboutBLDE-21-006041 Commonwealth of Official Use Only ,..pachusetts / ` Permit No. BLDE-21-006041 BOARD OF FIRE PI PENTION 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 ..ASE PRINT IN INK OR TYPE ALL INFORMATION) Date:4/20/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives nonce of his or her intention to perform the electrical work described belo n� Location(Street&Number) 67 SWIFT BROOK RD 77 -�2 O J Owner or Tenant Patrick)Reid Telephone No. Owner's Address 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: Adding 2nd bathroom. 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 2 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool g bove ❑ �rnd. ❑ No.of Emergency Lighting rnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 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 0 Other: 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 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. NSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee 'rovides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such overage is in force,and has exhibited proof of same to the permit issuing office. ;HECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) certify,under the pains and penalties of perjury,that the information on this application is true and complete. IRM NAME: icensee: Signature LIC.NO.: japplicable,enter"exempt"in the license number line.) Bus.Tel.No.: address: Alt.Tel.No.: Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: 1WNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But gnature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. wner/Agent ;nature Telephone No. PERMIT FEE:$75.00 0-;)aa- (WAILS el) ikfifi)—ilattitive rb &Ape,- (16 et leci) &Ada it- t ' -2-4 Commonwealth of n asaaclituelts Official Use • A/ cc^ c� Permit No. -� 4 "1 2aparinssal o .airs Serviced 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(MK) 547 CMR 12.00 (PLEASE PRINT IN INK OR 91PE'ALL INFO NATION) Date: ill/ 6J 1 City or Town of: Jo t) l Or iii O 044o To the Inspector of Wires: By this application the undersigned gives notice h' or her intention to perform the electrical work described below. Location(Street&Number) 10? S Lis): 4'1- iS 'a O K (2 Owner or Tenant 0 QW V i Telephone No. 71�- ( O -o a a' Owner's Address(p 1 J ,;l � )'3r OO i. l cl SO u-til \o rrn UU 4' i 1 Oilti a 02 lo tog lls this permit in conjunctioni1 with a b C, Yes g No ID (Check Appropriate Box) Purpose of Building CJ(cJl an C)d{ LA- 1I )C1Y1 Utility Authorization No. Existing Service(O b Amps i 30/,AOVolts Overhead[ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity I f'.p p d e(- [_a10'A-rn�J -44r! , o r..,A ,1y� Location and Nature of Proposed Electrical Work: (27 3 t 44- a roc) , �c i SO vac T o O`�h 119 9 .. (1 M l tin d f3edinrooa Completion of thefollowingtabk my be waived by the Inveotor of Wires. ,1 No.of Recessed Luminaires No.of Ceti.'asp•(Paddle)Fans Tr an Tea osformers KVAf Tot 'i No.of Luminaire Outlets Ot No.of Hot Tubs Generators KVA Above In- No.of mmergency Lighting 4' No.ofLuminai� Q Swimming Pool and. ❑ mod, ❑ Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No,of Zones No.of Detection and No.of Switches ( No.of Gas Burners Initlating'Devices Itl No.of Ranges No.of Air Cond. Ton' No.of Alerting Devices No.of Waste Dlaposers "Heat ootta�h Number Tons KVI'___ Det of ect Self-Contained No.of Dishwashers Space/Area Heating KW Local❑ n 0 Other No.of Dryers Heating APPWaces ' SecuriNo.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Sins Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No,of Motors Total HP Telecommunications Wiring: Y eNo.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: -5 0 •190 (When required by municipal policy.) Work to Start: 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 certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.; (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: 'Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: tic.No. OWNER'S .SURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by y my signature jw.I, r .y waive this requirement. I am the(check one)❑owner 0 owner's agent. O ge , 77'i- 1120D-poay PERMIT FEE:$ 76•c Signature . . ► __ . � — ,� ' Telephone No.