The URL can be used to link to this page

Home My WebLink AboutBLDE-21-003503 Commonwealth of Official Use Only it_AN Massachusetts Permit No. BLDE-21-003503 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.l/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:12/19/2020 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 SLEEPING DOG PATH Owner or Tenant DAVIS GEORGE F Telephone No. Owner's Address DAVIS ELIZABETH N,23 SLEEPING DOG PATH,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Approp ' Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 O �� At'w et [/ New Service Amps Volts Overhead 0 Undgrd 0 _`C�, ' ` •Ole 7 Number of Feeders and Ampacitye 'e*if i,, Location and Nature of Proposed Electrical Work: Wiring of new detached garage. O Completion of the following table may be waived by the • • ires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of To 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 In►tiatine 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 ❑ 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: 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: 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 —772 4 Y+-, c-eJ%T t2:>ta— LC IL 124-2 7-c) 0 .e,EA . t 2 t'3 14 CommonWOa O`Maaaaclueasits OfficialUse Only • • I, 2cc��rr�� Permit No. A-3 S�3 epartmeni o` &,vicss j i ji- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) 0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 A •- (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 12.I )`%`?-o City or Town of: Yo►.rrlvoll.1 To the Inspector of Wires: A By this application the undersigned gives notice of his or her intention to perform the electrical work described below. o) Location(Street&Number) 23 S)c.-fi• Dr," 174,4'L i yGMMo✓ O-Nr4— r Owner or Tenant (.9uar9J . O.4-vi S Telephone No.(51)IG)1-1 to-)t-U4o I Owner's Address Set rt-( 1Is this permit in conjunction with a building permit? Yes ®. No ❑ (Check Appropriate Box) Purpose of Building el.4,64,4e1 &es.r4 r IA 5/44-c- elotkUtility Authorization No. 1 Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Q Number of Feeders and Ampadty -5 Location and Nature of Proposed Electrical Work: Ntw Pe_A-e4cAsx , [, i._ ,e 7-ruvh 1 Svb - Pa...A. Ty've-edt I tqw4-1- << (L-up i' 5 V Completion of diefollowingtable m be waived by the Inspector of Wires. Total �.1! No.of Recessed Luminaires No.of Ceil.-Snap.(Paddle)Fans Trans KVA � Transformers KVA r1 No.of Luminaire Oudets No.of Hot Tubs Generators KVA n No.of Luminaires g�� p Above ❑ In- ❑ a of Emergency Lighting °g grad. Battery grad. Battery Units No.of Receptacle Outlets No.of Ofl Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na n IDetection and Initiating Devices 1 r No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tops KW No.of Self-Contained Totals: ..Torn ___._._.___.. D n/A�D� No.of Dishwashers Space/Area Heating KW Local 0 Comsetres leCn ❑ Other No.of Dryers Heating Appliances KW Security s•* Na 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 Tel ecomm Na of Devices so rs Wtr�g or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 5, t2 D O — (When required by municipal policy.) Work to Start•. 121151 20 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 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,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: 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)f'owner ❑owner's agent. Owner/Agent Signature �l/t Telephone No.S? 'Mt.- 11. w I PERMIT FEE:$