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Home My WebLink AboutBLDE-22-001254 A0 Commonwealth of Official Use Only r � Massachusetts Permit No. BLDE-22-001254 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:9/2/2021 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) 29 OLD CEDAR LN Owner or Tenant BELL JACK R Telephone No. Owner's Address BELL CAROLYN P, 29 OLD CEDAR LN,SOUTH YARMOUTH, MA 02664-1027 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: Replacement furnace Completion of the following table may be waived by the 1n�pector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers O KVA No.of Luminaire Outlets No.of Hot Tubs Generator A No.of Luminaires Swimming Pool bovernd. ❑ grnd. ❑ No.of E Li .:: Battery No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALA' ' P oCp Zo s v No.of Switches 1 No.of Gas Burners 1 No.of Detection an' Initiating Devices Q /� No.of Ranges No.of Air Cond. Tons Total 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 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: (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: ANDREW G THOMAS Licensee: ANDREW G THOMAS Signature LIC.NO.: 22152 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 ECHO LN, CHATHAM MA 02633 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: $50.00 ? �rz re6(. 2mey�i %%Y tii2 s Pk=ir1rr".�A ol. (k( (2.t C/� aa// // Official Use Only ommonwealth o/�a.�aachuaetf.� P t c� c'7 n Permit No. E,ZZ—t2...5-1+ .I o Apartment o/.}ire Jervicea lT._�_1 Occupancy and Fee Checked ' ate°� 1/07]BOARD OF FIRE PREVENTION REGULATIONS [Rev. .. (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g/A G IA 1 City or Town of: )/6k((ho✓i 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) a 9 c, a C'c_d a f 1,0 Owner or Tenant V)cl( Telephone No. ' Owner's Address a 9 d 0 L,cl t I 1 C n K._ Isthis permit in conjunction with a building permit? Yes ❑ No 2- (Check Appropriate Box) Purpose of Building St S <.A 1•" ) Utility Authorization No. Existing Service ),°° Amps 1a o / a4 0 Volts Overhead ❑ Undgrd 17 No.of Meters New Service Amps / Volts Overhead n Undgrd n No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ty,'c, c)Nt f i kc<n i AI of N4.(.t /a F1 oc,- iY r Completion of the following table may be waived by the Inspector of Wires. No. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans 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 L No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners t No.of Detection andInitiating Devices No.of Ranges No.of Air Cond. Total Tons 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 1=1 Connection ❑ Other Connection j No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications NofDeieorWiringg No.of Devices Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: ,C 0. (20 (When required by municipal policy.) Work to Start: S/1 14/1 1 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 EN BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Tlice 'ts rlcC4rckl St{ytcYC �nL LIC.NO.: as I 5 A-A Licensee: �, f) ,-10-- ",cignature LIC.NO.: (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: (_01?-.S3 -..& ?93 Address: V rt.Lit) Ictl Alt.Tel.No.: *Per M.G.I.. c. 147, s. 57-61,security work requires Department of Public Safety"S"License: I,ic.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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ c- 3,.,- t.4/3 rL617 0.44 z/[)✓4 -r,z.4--�vs 14)(644 vlt s /3 Li 16?i ,