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Home My WebLink AboutBLDE-21-007353 Commonwealth of Official Use Only L. ,E) Massachusetts Permit No. BLDE-21-007353 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:6/17/2021 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) 63 TAFT RD Owner or Tenant RITCHIE MAUREEN Telephone No. Owner's Address 63 TAFT RD,WEST YARMOUTH, MA 02673 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: Septic pump&alarm 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 PoolAbove ❑ 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 1 Totals: Detection/Alertinc 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 Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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: BRIAN A SMITH Licensee: Brian A Smith Signature LIC.NO.: 24307 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 GELDING CIR, BARNSTABLE MA 026301503 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: $50.00 (U2,cl (/21/ ( i% •••••,, • ' i 1. 1 ,,R ` l '� • • � mnueatz a/ aachude1 •g oficialUse Only , ` j 3, -='.,..,i.„---,-- i t •• c� c7 PCLmmtNp. EV-7 363 t ..S c ay11 . <Uepartment o/ `ire Services Z1ti-- � r • Occupancy and Fee Checked r ItOARD OF SIRE PREVENTION REGULATIONS - v11071 lerfsre blank] ) - • APPLICATION FOR PERMIT TO-PERFORM ELECTRICAL WORK . AIlwork to be peiormed d.accordance with.the Massachusetts Nedrieal Cock(MEC),52 GM 12.00 _ •41\%., . . (,.._\,, �PLEAS`EP.RtNTININKORTYP ATE JATORM227019• • Date e..� � = • Cityor Town o To_tlze ecto o tares: By this'application the undersignednotice o his or her intention to pez£o�fie electrical wank described below. ' • • Location(Street&Number) ' Gam. .,/ ?2 a ., . Owner or Tenant . /NA U, A/ ;e/771 /4 . Telephone No. • - ' ' •Owner's Address ,_1 ,"• . Is this permit in conjunction iW a buuldhngpermit?. Yes ❑ No (C heckAppropriate Box) . ' •- • Purpose of BmTding G 7, • -• • • -- Utility Authorization No. - . •Existing Service /Dk Amps /� ( Ye)Volts _ Overhead[Undgrd 0 No.of Meters /-. -New'Service Amps I. Volts Overhead❑ Undgrd ❑ • No.of Meters ` .Number of Feeders and Ampacity, • Location and Nature of Proposed Electi.icai Work: / /,vC O��J.c ,J .7 - Completion,o.the followtng table may be waived ly the Inspector of Fres of t . No.of Recessed Lim>inases • No.of Cee.-s usp.(Paddle)Fans ;NTraa ormers TKVo A- • No.of Lnminaire Outlets. - No.of Hot Tabs - - Generators KVA o• • _. - : Y- No.of.Lu aaess:-- ._ . swionmingrool- -fie-te a -0 g __o.of Lmergency Lighting l�, - No.of Receptacle Outlets No.of Oil Burners • -,FIRE,ARMS No.of Zones • _ - No.of Swcltes • No.of Gras Burners No.of Detedin-n and . gDevices' No,of ftaoges No.of Air Gond, Tom - No.of Devises Tons Alex-tin' No.of Waste Disposers Heat Pump Number Tons KWi)etecfionIAl Self-Contained cruise Devices • No.of Dishwashers - . Space/Area Heating Kw . L0 unit in 0 Otber • • Local. E:oM miec�io No.of Dryers H APPTiances spy -Security -* • No_of or Ecrowalcnt No.of WaterKW No.of . No. •Data Wiz$hg: • Signs • No.of Devices or Eguiivvaglent No.Hydromassage Bathtubs No.of Motors / Total HP/1 cofo Door TelEWinvii alert OTHER: • • • .4ffirri additional detail if rlasfrotr4 or airegard by the IrispednrofWtres Estimated.Value ofElecrical Work {When requiredby monidpalPoliy) Work to Start • Inspections to berequested in ice with MEC Ride 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the peafamance of electrical work may issue unless . She licensee provides proof of liability insuranise inclutBng completed operation"coverage or its sabstanfial equivalent The undersigned certifies that such coverigtism force,and has exhibited proof of same to the permit issuing office. -- - .. CHECK 01 _INSURANCE ON) 0 . OTHER D (sr ) - •• . •• - . . . : Icy,=do-Mel"' w dP o Pte,that the information'„t�,,,,. ,,,-f;els free and complete - • - FIRM NAME: -. -a ._-7,971/ j/1// . --��.. - LIC.NO.ic.7(107 • I a Q • �� 2 .t' n ) si natm e//'� — - LIC.NO.: 7 • tlfaw ez L.� G�� G rl . ` ` ' .ir'-�/ Bids.Tel.No. Gl"t - 7 7,9 Address: / . -/C�� Alt.TeL No» • - *Per M.G.L.c.147,s.57-61,secadi-y work requires Department of Public Safety"S”License: Lic.No. - • .- OWNER'S INSURANCE WAIVER: I am&vial e.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 ❑owner's agent. OwnerlAgent • Signature Telephone No. . . • P RIerT.FEE:$ 5D"1 •