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Home My WebLink AboutBLDE-22-002862 OP r Commonwealth of Use Only Permit rrnttNo. BLDE-22-002862Official 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:11/17/2021 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) 69 RIDGEWOOD DR Owner or Tenant HARTNETT RICHARD G Telephone No. Owner's Address HARTNETT DONNA M, 69 RIDGEWOOD DR,YARMOUTH PORT, MA 02675-2346 Is this permit in conjunction with a building permit? Yes 0 No 0 Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 gNo.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 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 No.of Luminaire Outlets Transformers KVA 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 I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 I certify,under the pains and penalties o perjury, that the information on this application is true and complete. FIRM NAME: LANCE A MACENERNEY Licensee: Lance A Macenerney Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 11149 Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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:$75.00 I t�`% - t-- r•� z� 1 WIN- 6- Z` sf+lm 1-Au� •U-614 V 7 j2( ee, (A3b 13036-Q erav -43 7iCA 1:\P-c. -3/3ohle_ -- . RECEIVED,' FD �, •,^,� NOV I 7 202�C'o aallJs o/j//a6aachrcastta Official Use Only 'f - c7� PermitNo. t)7� 6z' r $-_ �� [DING U 41 e, ni of..Tire-geruicee _ _ aRTrviE NT Occupancy and Fee Checked .4 ,,,, .-.. —_ a • - :_e. --FIRE 'REVENTJON REGULATIONS "' (Rev. 1/07j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK cJ All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR4477019 City or Town of: Date: I 1 { ` Bythis { {4��; '� �' To the Inspector ofWires: application the undersigned gives notice of his or her intention to � perform the electrical work described below. Location(Street&Number) (,, 1 ( v1. Owner or Tenant ' t Lkc1 —A I-} x-k r\= - Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. € `) Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters CI'' New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed EIectrical Work: 130,\ C.,c)ti'.f Ve t,,Cs ,e_ Completion of the followinktabk may be waived by the&vector of Wires. No.of Recessed Luminaires No.of Ceil-Soap.(Paddle)Fans No.ofTotal No.of Luminaire Outlets Transformers KVA µ No.of Hot Tubs Generators KVA i.. No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting hind. Bind. ❑ Battery Units No.of Receptacle Outlets No.of On 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 Heat Pump 1 Number I Tons m KW No.of Self-Contained No.of Waste Disposers Totals: w"`" _......._...._..�_w._..._._.__ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW 1 ❑ Municipal No.of Dryers Heating Appliances KW ��Systems:* 0 'No.of Water No.of No.of No.of Die or Equivalent Heaters Signs Ballasts ' No.Hydromassage Bathtubs No.of Motors Da No.a f or Equivalent Total HP Telecommunications W F ,�, • OTHER: No.of Devices or Ea nt Attach additional detail lfdesireci or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When 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 liability insurance including"completed peg overag a of electrical work may issue unless undersigned certifies that such coverage is in force,and has exhibited operation"oof coverage or its substantial equivalent. The CHECK ONE: INSURANCE 0 BONDproof of same to the permit issuing office. 0 OTHER 0 (Specify;) I certify,under the pains and penalties ofperjury,that the information on this FIRM NAME: — ,��t_`��,"*\ application is true and complete.p� L �� LIC.NO.• f t Licensee;�� . / 1"�C'�.' . (If applicable r Y i '� Signature LIC.NO.: exempt"rn the license mber�ins.) Address: (� i YZ i c1 �'��'r' 1 l) Bus.Tel.No. �� 7 5� � *Per M.G.L.c. 147,s.57-61,security work s(Y��(\ �� requires Department of Public AR.Tel No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability� r Lic.No. required by law. By my signature below,I hereby waive this • owner coverage normally Owner/Agent requirement Iam the(check one A owner / owner's a.:ern. Signature Telephone No. PERMIT FEE:$ vv