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Home My WebLink AboutBLDE-22-001174 Official Use Only e v 1�� Commonwealth of Massachusetts Permit No. BLDE-22-001174 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:9/1/2021 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) 23 ELMCROFT WAY Owner or Tenant VENEZIA LAWRENCE E Telephone No. Owner's Address CHARLTON-VENEZIA NANCY,23 ELMCROFT WAY,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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: Remodel kitchen 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 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 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 ❑ 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,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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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 0 owner's agent. Owner/Agent Signature Tele hone No. PERMIT FEE:$100.00 q/3/ 3/1/1' 1 - ?•7/1 Use Commonwealth of Massachusetts OfficialOnlyh b`� ' *-- - t Permit No T12 t l Department of Fire Services Occupancy and Fee Checked ?,-��'- BOARD OF FIRE PREVENTION REGULATIONS Rev.9/05 ` 1 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cod (M EC),527 CMR 12.00 PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ( ),/ City or Town of: Ic r yu )*\ To the Inspector of Wires: By this application the undersigned gives notice of his or hp r intention to perform the electrical work described below. Location(Street&Number) c 3 , el►YtC►'0 'l� kop J Owner or Tenant l,U aOa_ s I\larlcl�I limn ice_ Telephone No.-7/11ou:--; f9 Owner's Address J Is this permit in conjunction with a building permit? Yes E No ❑ (Check Appropriate Box) Purpose of Building J A.1'( I I Utility Authorization No. g Existin Service .--) Amps /I r/ Volts Overhead ❑ Undgrd Y No.of Meters New Service Amps / Volts Overhead ❑ Undgrd [1 No.of Meters Number of Feeders and Ampacity ,. Location and Nature of Proposed Electrical Work: 11 J+ .ke n ro(6h r-in IS)`') Completion of the following table may be waived by the Inspector of Mies. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- -No.of i✓mer.gency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones "No.of Detection aid No.of Switches No.of Gas Burners Initiatin Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local DI Municipal Connection Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.of Water K`,i, No.of No.of Data Wiring; Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring' No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value oC Ele trical Work: (When required by municipal policy.) Work to Start: I 3b1c)-1 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 liccnaec 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:P! 4 NE ELECTRIC.) I NC..., LIC.NO.:63°L�1- j Licensee: IN LEV, W• sky NE Signature /. LIC.NO.:2. . (If applicable,enter "exempt" in the license number line.) , Bus.Tel.No.: _ Address: 2.0. BOX Oct SOUT ii tc t V 0VD l0 1 Alt.Tel.No.: Z I .b L *Security System Contractor Incense required for this work;if applicable,enter the license number here: 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 PERMIT FEE:$ Signature Telephone No. ,