HomeMy WebLinkAboutBLDE-21-002447 Vc. 1 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-002447
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.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:11/3/2020
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 electncal work described below.
Location(Street&Number) 5 SALT MEADOW RD
Owner or Tenant HADDAD CATHERINE L TR Telephone No.
Owner's Address C L HADDAD TRUST, 10 S WALPOLE ST,SHARON, MA 02067-1602
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 120/24( Volts Overhead 0 Undgrd 0 No.of Meters
New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: new home with 200 amp underground service
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 60 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 Uni .
No.of Receptacle Outlets 70 No.of Oil Burners FIRE AL„0!,:::: o.of Zo e/
No.of Switches 50 No.of Gas Burners 2 No. t ectio j
Ini Sia c O
24
No.of Ranges 1 No.of Air Cond. 2 TotTons 4 No. 1 ' 'ce /
No.of Waste Disposers Heat Pump Number Tons H. KW No.of Self- : , i 0
Totals: Detection/Aler' 2 ii so
No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municip: ■ er:
Connection
No.of Dryers 1 Heating Appliances KW Security Systems:* 0
No.of Devices or Equivalent
No.of Water 1 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: 11/03/2020 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: KYLE HAMMOND
Licensee: Kyle Hammond Signature LIC.NO.: 21301
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:68 Eden Park Dr, North Attleboro MA 027602830 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: $180.00