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HomeMy WebLinkAboutBLDE-22-002532 _N\ 1 Commonwealth of Official Use Only At"t '; Massachusetts Permit No. BLDE-22-002532 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:11/3/2021 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) 27 WINSOME RD Owner or Tenant WATSON PATRICIA Telephone No. Owner's Address 73 DESERT SANDS LN,YARMOUTH PORT, MA 02675 e..�y Is this permit in conjunction with a building permit? Yes 0 No 0 ( late Box) J.Y('00 Purpose of Building Utility Authorization tli. : A,`Existing Service Amps Volts Overhead 0 Undgrd � �. New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement of exterior service damaged by storm. 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- ElNo.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. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local 0 Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Data Wiring: Siens 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 olperjury,that the information on this application is true and complete. FIRM NAME: Daniel 0 Wilkey Licensee: Daniel 0 Wilkey Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 32288 Address: 168 CENTER ST, SOUTH DENNIS MA 026603744 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE:$50.00 I 'd\--?1/-k‘11-5"( e."-PLACkat/16)INC-- ©l 5 S1 4 PC1A.4— or 41rAEb(tu( ) 1 1(3 7-24 kE ammonweaiL o`/flaaaacbuastla Official Use Only v,, / P r�22 -`Z-53 a ti � t a/ S&Friars Permit No. BOARD OF FIRE PREVENTION REGULATIONS "pal] and Fee Checked ���` ���� [Rev. 1/07] (leave blank) 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 TY EALL INFORMATION) Date: MJV Al City or Town of: isin To the Inspector of Wires: By this application the undersigned gives notice of his or her i tion to perform the electrical work described below. Location(Street&Number)W �7 LU jnz A. Owner or Tenant �d f TT c (� j _ Telephone No. Owner's Address Is this permit in conjunction with a buipilig permit' Yes El No ) (Check Appropriate Box) Purpose of Buadin � f-M t ,LIc U tarty Authorization No.700.3 Li 00 Existing Service 1Q0 Amps 1 / Volts Overhead[, Undgrd❑ No.of Meters 1 New Service Amps I Volts Overhead❑ Undgrd El No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: l'n5M'f U is 4 c T him � C L -- dow4 a L1t 6-tQ`� f L �t7l Completion of the followintable may be waived by the Inspector of Wires. No.of Recessed Luminaires Na of Ceti.-Snap.(Pale)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool gee ❑ In- ❑ N .of Emergency Lighting grad. Battery Units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS }No.of Zones , No.of Switches No.of Gas Burners Na of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers HeatP Totals:I Number l Tons [KW Na of Self-Contained ( DetecrtontAlertmg Devices No.of Dishwashers Space/Area Heating KW Local 0 Na of Dryers Heating Appliances KW Security Systems:*O°n ❑ Other No.of Water KW No.of No.of l or Equivalent r No. tla is 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: Soo (When fquired by municipal policy.) Work to Start: Inspections 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 [ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NA LIC.NO.: Licensee: Signature LIC.NO: Z2. 8 E (If applicable,enter"exempt"m e license n line.) Address: Bus.Tel.No.: ryrye�/ *Per M.G.L.C. 147,s.57-61,security work requires "S" Alt.Tel.No.: �i0� tp Department of Public Safety 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 Owner/SreAgent one)❑owner ❑owner's agent. Telephone No. I PERMIT FEE:$ I