The URL can be used to link to this page

Home My WebLink AboutBLDE-23-000740 Commonwealth of Official Use Only �E Massachusetts Permit No. BLDE-23-000740 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:8/12/2022 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) 21 AZALEA LN Owner or Tenant JENNIFER WALLACE Telephone No. Owner's Address MA 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: Split A/C 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- O 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 lnitiatine Devices No.of Ranges No.of Air Cond. 1 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 ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Sims No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: .No.of Devices or Eauivalent 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: STANLEY D ANDREWS Licensee: Stanley D Andrews Signature LIC.NO.: 15248 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:201 HEAD OF THE BAY RD, BUZZARDS BAY MA 025325640 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: $50.00 btek 0(./6( 2)/� UI V 14 ConrewwwaatLk`�fjOfficial o`e`i��aaaso�iuedte t��Use��Only, f • zr 20,parimeat�l..tins J.rvic.s Permit No. �-�C `rt' at Occupancy and Fee Checked ,, BOARD OF FIRE PREVENTION REGULATIONS [Rev. lro7] leave blank) GS 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 T'PE ALL INFORMATION) Date: a°/i a-/a 2 City or Town of: AA-Wa.o VI1..._ To the Inspector of Wires: 1 By this application the undersigned gives notice of his or her intention to perform the electrical work described below. s Location(Street&Number) r-I 142.ai e c .. L A Owner or Tenant Telephone No. Owner's Address C-ArN -e Co Is this permit in conjunction with a building permit? Yes 0 No 1g (Check Appropriate Box) V Purpose of Building Utility Authorization No. Existing Service di d Amps I ga ?le Volts Overhead Ila Undgrd❑ No.of Meters 1 N New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: t,J,r,n5 a Ir ivi;K j S'p i,4- Sy sf-e i. V1 Completion of the followinktable inMg be waived by the Ingtector of Wires. No.of Total Ul No.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans Tra sformenKVA 4 No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- Iva.of emergency Ltgtit[ng 4 No.of Luminaires Swimming Pool tend ❑ arnd ❑ Battery Units J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices 1 U No.of Ranges No.of Air Cond. Tunil No.of Alerting Devices Heat Pump Number Tons KW , .'No.of Self-Contained No.of Waste Disposers Totals: r__.. .. ._____......__. .. Detection/AlertDev ices No.of Dishwashers Space/Area Heating KW Local 0 MCeinnectton 0 Other No.of Dryers Heating Appliances KW SecNo.yof Devices or Equivalent No.of Water No.of No.of ICV' Data Wiring: Heaters Signs No.of Devices or ' , dent No.Hydromassage Bathtubs No.of Motors Total HP Tel of or : , •nt OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value o Electrical Work: (When required by municipal policy.) Work to Start: a 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 wait 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 S4 BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties ofperjary,that the information on this application is true and complete. FIRM NAME: 13_,0.g zoa dS 3eAy Fled rt G LIC.NO.: /5;79 SI,4 Licensee: ►S 1e�..1 --0_ 4kclr.+•+s 7z Signature , a-- LIC.NO.: (If applicable attar' t t license number line Bus.TeL No. 7SR—.7/00 Address: go/ a�0 Le y 12 cl 15v ZZ. glyI MA. O 26'3a_ Alt.Tel.No.:5 011-41411—"'9 7 *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)0 owner 0 owner's agent. Owner/Agent I PERMIT FEE:a Signature Telephone No.