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Home My WebLink AboutBLDE-22-000953 /'0" \� ommonwealth of Of use only 7 � Massachusetts Permit No. BLDE-22-000953 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:8/19/2021 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) 57 GORDON LN 5-/A--‘91-832-41 Owner or Tenant WEST EILEEN M Telephone No. Owner's Address 130 GAYLAND RD, NEEDHAM, MA 02492 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: Remodel basement room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 5 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 5 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices TNo.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 0 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 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: DAVID M HAWKINS Licensee: David M Hawkins Signature LIC.NO.: 31112 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN,YARMOUTH PORT MA 026752252 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: $75.00 w,. 944 .) J/A ti47/-zt tccc,544 LIA)) I- \, ' MAWfVIat gddOCL„delbOfficial Use Only cx�4 i. n Permit No.L (� L .:1' • Services � BOARD OF FIRE PREVENTION REGULATIONS v1/0 Occupancy Fee Checked [� (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M 527 pa 112.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: r r(/?)1 City or Town of: ,:tri,,,.: nt i�' " To the Inspector of Wires: r By this application the undersi gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) j j (;-i p J L—tJ �. Owner or Tenant I L .) >✓(/r�3 j Telephone No. z Owner's Address ! 36 G-, .-c.. ,V. A D r/rr �^.d ((—/ci N4 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Fi,v f s rf f v.,. _cru PA-s-e feu,8v+J"7 Utility Authorization Na • Existing Service ///i- Amps /ZOl,Atic Volts Overhead Ef Undgrd 0 No.of Meters 1 New Servkx Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampaclty �jA/� /O 24- Location and Nature of Proposed Electrical Work: ri Nis r� 5<a Aiw 1 a yin ui;'� 1'S" g,.„ tird Completion of thefollowingtable inw be waived by the Inspector of Wires. tit No.of Recessed Luminaires Na of Cell-Snap.(Paddle)Fans Na of Total c Transformers KVA ='t No.of Luminaire Outlets Na of Hot Tubs Generators KVA K.--\ Ap Na of Luminaires Swimming Pool Above ❑ In- ❑ NO.of Units Lighting grad. grad. Battery Units e' No.of Receptacle Outlets 5- Na of Oil Burners FIRE ALARMS Na of Zones lcNNa of Switches 4' , No.of Gas Burner °'of DetectionDand t i.? Na of Ranges No.of Air Coad. Ton` No.of Alerting Devices Waste Dbpesers Heat Pump Number Tons KW___'No.of Self-Contained Na Totals: I Detecllon&AlertiFkDeviea Na of Dishwashers Space/Area Heating KW Logi 0 C nuection 0 Other Na of Dryers Heating Appliances KW Security Na of stems.evim or Equivalent No.of Water , No.of No.of Data Wiring: HeatersSigns Ballasts Na of Devices or Equivalent elecomunications No.Hydromassage Bathtubs No.of Motors Total HP � f leviers or EgWd est OTHER: Attach additional detail if desired;or as required by the Inspector of Wires. Estimated Value of Electrical Work: G�U (When required by municipal policy.) Work to Start: r C) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabiliinsurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such cov a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cm*,under the pains and penalties of perjury,that the information on this application is tate and complete. FIRM NAME: R LIC.NO.: S�AUL Licensee: ) Jff`u/A/Ai c Signature 4/91 -101,,01�/&AA, LIC.NO.: 2/.//,2 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: ')7 gl Ar 2 d S' Address: %y r'N�./G. 3 m✓-'.-/S 4-/t/ yp o. fl Po r r Alt.TeL No.: 'Per M.G.L.c. 147,s.57-61,security wor)'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)❑owner 0 owner's agent. Owner/Agent `PERMIT FEE:$ Signature Telephone No.