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Home My WebLink AboutBlde-22-004341 Commonwealth of Official Use Only • A + Permit No. BLDE-22-004341 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:2/4/2022 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) 2 MAYFLOWER TERR Owner or Tenant SIENKO DEBRA F Telephone No. Owner's Address 172 LINDSEY ST, N ATTLEBORO, MA 02760-4730 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Clean up bathroom wiring&take responsibility for work done by others. 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 Initiative Devices No.of Ranges No.of Air Cond. Toot l No.of Alerting Devices Tn 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 ❑ 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 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: 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: William H Allen Licensee: William H Allen Signature LIC.NO.: 13699 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 CAMMETT WAY, MARSTONS MLS MA 026481508 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 Telephone No. PERMIT FEE:$200.00 2 (2Z : RECEIVED =__= •FEB 04 202Z�° ca °1a6sac � ffi��Use my i■_= -=q _1ri=I_._ .= t= Permit No. � ' __ )4ILUING LiCNAR-1- °�J"'Serviced t ' Occupancy and Fee Checked r- - -REVENTION REGULATIONS [Rev- l/07] (leave blank) _ A D )I Ir A rtnii rr,r, r.�.�..._ -- _ ' :=• . : :.�: + ;� i �i;rtt 1 r v r-crruKm tLt% I KICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ),527 CMR 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: LI aZ City or Town of: YARMOUTH To the Inspec or of Wires: By this application the t,indersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 02 �C.-0 2 i-G�- Owner or Tenant be b prey 1 Q,A) KG Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building " - 1-( Pay,?64444 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd gr ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd i'r ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: L4',C..-19-^ vt, . (..)I f'Lt>"L l �}9�c1 C2��c Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KV,e, No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. arnd. 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. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I '� Detection/Alerting Devices J No.of Dishwashers Space/Area Heatin KW Municipal g L0�Q Connection Other k No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of 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: AAttach additional detail if desired or as required by the Inspector of Wires.Estimated Value of Electrical Work (When required by municipal policy.) V 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 1 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 ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME/ LIC.NO.: /,j 6 y' Licensee: v/)7 l eA___ Signaturg �- LIC.NO.:( 3(off 3 �'� (If applicable,enter "exempt"in the license mr er 1tn�e.)� " �q. Bus.Tel.No.: �S�'�-3� . Address, c2 S) {¢/n/ C�-1 ' �T V/G c E 0(�� 1. O3 c3-D- Alt.Tel.No.: J "Per M.G.L. c. 147,s.57-61,security work requires 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 S required by law. By my signature below,I hereby waive this requirement. I am the(check one)Elowner 0 owner's agent Owner/Agent ' Signature Telephone •No. I PERMIT FEE: $ I FROM THE DESK OF WILLIAM ALLEN ELECTRICIAN INC. February 22, 2022 William Allen Electrician Inc. Journeyman License 13699B 251 Main St. Centerville,Ma 02632 wallenelectric2000@gmail.com To whom it may concern, William Allen Electrician Inc.takes on full responsibility for the electrical work performed in the bathroom at 2 Mayflower Terrace in South Yarmouth. Thank You, William Allen