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Home My WebLink AboutBLDE-22-004608 Commonwealth of Official Use Only 1-4Massachusetts Permit No. BLDE-22-004608 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/071 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:2/18/2022 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) 10 CORDICK RD Owner or Tenant SCOTT JOHN W Telephone No. Owner's Address SCOTT JULIE B, PO BOX 511, READING, MA 01867 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: Wiring for bathroom. 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 Initiating Devices No.of Ranges No.of Air Cond. TotaloNo.of Alerting Devices 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 ❑ 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 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: ADAIR MARTINS ELECTRICAN Licensee: Adair Martins Signature LIC.NO.: 55688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:215 Palomino Drive, Barnstable Ma 02630 Alt.Tel.No.: 5088156173 *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: $75.00 a �2�r ,va. .. .12,,,,,, ct7c... ,..... (Lau Y l ,4Co saw f Mamac�.t� 0. ot�cause _ Permit No. ZZ. _' " 2ep"'.ni of Jw.*gawkedvcee; _-' , BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee eked [Rev. !/07] (leave blank) • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK MI work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 -� �(PLEASEPRINT IN INK OR TYPE ALL INFORMATION II City or Town of: Date: C7 2 YARMOUTH To the Inspector of Wires: y this application the undersigned gives notice of bis or her .tention to perform the electrical work described below. Location(Street&Number) / _Aa, •L 1 Owner or Tenant i e til An4 .. Vol AIWA V �� a Telephone No. cC Owner's Address -j N Is this permit in conjunction vii a building permit? Yes IC No ❑ (Check Appropriate Box) lpurpose of Building p,n ' 1 Utility Authorizadon No. xisting Service Amps / Volts Overhead agglinigg 0 Undgrd 0 No.of Meters Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: e, . t i i, to i id Lb ,,tetton, the ollow : table m, be waived. No.of Recessed Luminaires No.of 'o.o the I for o Wires. C�-Suap.(Paddle)Fans Transformersota A No.of Luminaire Outlets Na of Hot Tubs 4' Na of Luminaires Generators KVA F Swimming Pool ',d e 0 n- ❑ ELI o 'mergency ' ;ng No.of Receptacle Outlets Batte Unita .,., No.of OU Burners No.of Switches CEMIMM No.of Zones No.of Gas Burners n a, it.7 :122 0.Inttiatia Devices No.of Alr Cond. °' Tons No,of Alerting Devices o.of Waste Disposers Teas Totals: .'u._ ,_r ons !, o.o Va on:t a , No.of Dishwashers Detection/Alertia Devices Space/Area Heating KW Local nn r , No.of Dryers Heating0 Connection 0 Otter Appliances KWy c e ; a o r `o.o No.of Devices or ' ,uivalent Heaters KW o.o Data Wiring: No.H dromassag S a Ballast No.of Devicesg� Y e Bathtubs No.of Motors e ecommu ,or ,T u at Total HPas f- .; OTHER: No.of Devices or ' . mt Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (Wh Work to Start: en required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the the'licensee provides proof of liabilityincluding"completed o performance of its subs al work may issueentunless insurance undersigned certifies that such coverage is in force,and has exhibited proof of same to thee or substantial equivalent The CHECK ONE: INSURANCE 0 BONDipermit issuing office. I cerAtfy,ander the 0 OTHER 0 (Specify:) FIRM NAME: • pa andye r' of' rjwy,that the Information on this applkat9on is true and complete Licensee: a t4, i / e Irl. /.� j m LIC.NO.: 5 —� al-applicable.ble.enter . 'in the lic a number in.l Ignature ► `' - LIC.NO.: f s 1.o . z s Y , . 1,4' , ‘440 . Bus.Tel-No.:- - - I}3 "Per . L.c. 147,s.57-6 security •rk requires . oAlt.Tel-No.: Mt3 required by OWNER'S INSURANCE WAIVER: I am aware that the Licensee od rSafety"S"License: Lic.No.es not have the liability insurance coverage normally w. SI � la By my signature below,l hereby waive this requirement. I am the(check one III owner NI owner's a:errs Owner/Ase Telephone No. PERMIT FEE:$