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Home My WebLink AboutBLDE-21-006571 Commonwealth of Official Use Only (t1 ) Massachusetts Permit No. BLDE-21-006571 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:5/13/2021 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) 8 NORTH MAIN ST Owner or Tenant Frank Cadwell Telephone No. Owner's Address 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 j New Service Amps Volts Overhead 0 Undgrd 0 No.of, +trs e Number of Feeders and Ampacity 4 ._) Location and Nature of Proposed Electrical Work: Dryer 4 .11^ O /2•2__Completion of the following table .i :e ei,• t . or of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of �►'� Transformers O p,, No.of Luminaire Outlets No.of Hot Tubs Generators VVVV No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units41 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 Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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: $50.00 .14 Conunonwsodk o`Makiaduoisito Official Use Only _ 'i c� Permit No. C'L...2...-1C r/ 2 c�i spartmeni o�,tns—cervical Occupancy and Fee Checked I BOARD OF FIRE PREVENTION REGULATIONS [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 TYPE ALL INFORMATIQ1f) Date: _____1_, City or Town of: South YaryY)0VTo 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) g Ahrli, nl)a n 371'P �Q� Owner or Tenant f�yik ��Itlp)' Telephone No.(00,3 9 6�j Q O Qi Owner's Address S nfnrY� ajr) ,14; r Is this permit in conjunction with a building permit? Yes 0 No to (Check Appropriate Box) Purpose of Building r„c,jckyice_ Utility Authorization No. 3 u Existing Service Z o Amps /Q-1 / Volts Overhead[r Undgrd❑ No.of Meters / • New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty ..___,t.,1 Location and Nature of Proposed Electrical Work: Ab D,•ver. Df2_,,,44._ 3 0 /a Y n v) Completion of thefollowingtabk may be waived by the Inspector of Wires. Total �t No.of Recessed Luminaires No.of Cell-Snap.(Paddle)Fans No.Transformers KVA f No.of Luminaire Outlets No.of Hot Tubs Generators KVA rx 'i No.of Luminaires Swimming Pool Above ❑ In- ❑ ' o.of Emergency Lighting grad. gond. Battery units �' No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners bio.of Detection and s. Initiating Devices t z' No.of Ranges No.of Air Coad. Tun l No.of Alerting Devices No.of Waste Disposers HeatZ p Number Toes KW otals: __.... D own/Self-Contained evices No.of Dishwashers Space/Area HeatingKW Local Man ❑ Connection ❑ Olhe �� rea No.of Dryers Heating Appliances KW No. Systems:* No.of Devices or Equivalent No.of water , No.of No.of DataWiring: Heaters Signs Bele No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications or WMi�n Na of Devices Equivalent OTHER: Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required 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 0 BOND 0 OTHER 0 (Specify:) I Certify,under the pains and pof pedury,that the information on this application is tree and complete FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.• Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$