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Home My WebLink AboutBlde-21-005963 Commonwealth of Official Use Only Permit No. BLDE-21-005963 .E 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:4/15/2021 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) 80 RUN POND RD Owner or Tenant Crowell 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel 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 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 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 No.of Detection and Initiating 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/Alerting 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 Signs 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: David W Springer Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:65 PINE GROVE AVE, HYANNIS MA 026012524 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<:_e_ii"( 41/2-40/2-‘ KE.._ q2A-4(2.4 4 -_ Commonwealth of riladeachwette Official Use Only P + }� .'i Permit No. (;3 gin : 11 i u Occupancy and Fee Checked I .' 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( C),527 CMR 12.00 y (PLEASE PRINT IN INK OR TYPE ALL INFO TION) .Date: y I1 ?\ City or Town of: VCa-MO To the Inspector of Wires: By this application the undersigned gives notice of his or her intention�perform the electrical work described below. .D Location(Street&Number) (YO VA PUc\,a + Owner or Tenant filrs C CO U l\ Telephone No. S- Owner's Address ,_ vIs this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) v Purpose of Building e lotAit A, Utility Authorization No. N Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters M New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters i Number of Feeders and Ampacity 7-1 A Location and Nature of Proposed Electrical Work: ,Pctikelive M re.it404 C. Completion of the followinvable may be waived by the Inspector of Wires. c. No.of Recessed Luminaires No.of Cell.Susp.(Paddle)Fans Tr oof Total Transformers KYA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmingPool Above In- No.of Emergency Lighting grnd. grad. � Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices l No.of Ranges No.of Air Cond. T ns No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of SeW Contained Totals: Detection/Alerting 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 No.of No.of KW Heaters Data Wiring: Signs 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 desire4 or as required by the Inspector of Wires. Estimated Value of Flectrical Work: 1 500, as., (When required by municipal policy.) Work to Start: 9 / 13/71 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 cover is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certifr,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: 5Q�E"n q.(„C ale��CIL. LIC.NO.: 21l 70 A Licensee: Day i 0 C'iVV1;��j' Signature 6,.. LIC.NO.: i 3 i-3`t (3 (If applicable.enter"exempt"fn the h�ense n r line) _ Bus.Tel.No.:SO 34t1 O k 3` Address: -70 Q i n S C cnAt ' Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work r uires 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $