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Home My WebLink AboutBLDE-22-003890 0Commonwealth of Official Use Only � 'E, 1 01 Massachusetts Permit No. BLDE-22-003890 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:1/12/2022 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 clow. f Location(Street&Number) 50 FAIRWOOD RD Yp- Jl. 6 l 43 Owner or Tenant KILEY EVELYN C Telephone No. Owner's Address 50 FAIRWOOD RD, SOUTH YARMOUTH, MA 02664 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 1 Location and Nature of Proposed Electrical Work: Kitchen remodel 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- (3No.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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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: DAVID W SPRINGER Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 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 Pr, LI 4,,,. ; t_ 13/7v k.6 Q 14 Commonwealth oieMaddachuoetld Official Use Only ` B ¢ / JJsloarimsnt o` s Permit No. •(2Z "---3 6 9 0 � so A z }irs a eked C. '• ,117 ,'1,I BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked .-4- [Rev . 1/07] (leave blank) s APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK J 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: I/)Z lZ Z 3 City or Town of: . YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her`` \'inte tion to performthe electric work described below. SO Location(Street&N mber) fo,(c WOO O d d i S 7 xr-i)v} 7.4 Owner or Tenant / Set t\O a d k (rgi tR.(,AUC Telephone No. 0 Owner's Address v_.4 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building d WfA1.A Utility Authorization No. Existing Service Amps J/ Volts Overhead ❑ Undgrd 13 No.of Meters CNewService Amps / Volts Overhead❑ Undgrd ❑ No.of Meters g `'- Number of Feeders and Ampadty 1 Location and Nature of Proposed Electrical Work: K, C\l,en cc f„�0 �, etfly COce 414 3 .n I �J J J, vi f u Completion of the following table m be waived by the Infector of Wires. CI' No.of Recessed Luminaires No.of Cell:Sasp.(Paddle)Fans No.ofd Total Transformers KVA 7.1 No.of Luminaire Outlets No.of Hot Tubs Generators ' KVA l' No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting Brod. grnd. Battery Units -•' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners "No.of Detection and i No.of Ranges Total Initiating Devices g No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals: Detection/Alerting )evices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection 0 °ther No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No,of Devices or Equivalent .r.. .. ...."' THER: - ~ Attach additional detail if desired,or as required by the Inspector of Wires. Ci'�'-"",wEA imated Value f El trical Work: �/60C) (When required by municipal policy.) LW N, o H-W k to Start: )1 D f Z2 Inspebtions to be requested in accordance with MEC Rule 10,and upon completion. c.t �I14 URANCE COVERAGE: Unless waivedp _ by the owner,no permit for the performance of electrical work may issue unless 14kC'1 Lth licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The - ersigned certifies that such cove,geis in force,and has exhibited proof of same to theermit issuing office. Q 3 1 CK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) p Int�6 --� rift',under the pains and penalties ofperjury,that the information on this application is true and complete. ------..._. � aaee:� � ,. � . P , LIC.NO.: Z1\7d L-------- G4- J ' r, Signature LIC.NO.: )3 2_ f 6 g (If applicable,enter"e empt' in the use number line.) ``f Bus.TeL No.: SO 3 h y O j 3 Address: 1 ,31,d0 5 �tt1M') t Tel.No.: *Per M.G.L.c. 147,s.57-61,security work reqs Department of Public Safety"S"License: Alt.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 Signature Telephone No. ( PERMIT FEE:$ 1