Loading...
HomeMy WebLinkAboutBLDE-22-003403 ar . Commonwealth of Official Use Only �. ,i Massachusetts Permit No. BLDE-22-003403 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:12/15/2021 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) 40 ALEXANDER DR ) 3hdne-•9370Owner or Tenant RESIDENT TelepNo. Owner's Address WARREN CHERYL A,40 ALEXANDER DRIVE,YARMOUTH PORT, MA 02675 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: Remodel room over garage Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 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- 1:1No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 9 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotaloNo.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 ❑ 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 Sinus 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:) 50 g 2-1/ ' .551-2' I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: GLENN W CRAFTS Licensee: Glenn W Crafts Signature LIC.NO.: 10020 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:72 COUNTRY CIR, SOUTH DENNIS MA 026602920 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 (Z,vr,04,1 I 4 24M.-- 6ecC e9 y/1 2.fitm_3 M >� j3% - Commonwealth Of Massachusetts official Use Only 4 . _ M_'9 Permit No. E22 J l 0 3 Department of Fires Services "- 1_ ' BOARD OF FIRE PREVENTION REGULATIONS (Revupanry and Feb Checked(Rev.9/05) (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.PF,ALL INFORMATION) Date: I Z. - 2 I City or Town of:. IC&S1Md 7t A a A To the Inspector of Wires: By this application the undersigned gives notice of his or her intention tc perform the electrical work described below: Location(Street&Number) ( () `��� ,A(C,,:1d 0-(-.2)\r` 1/4-1•--0_- Owner or Tenant \./00‘.1k-04-\./00‘.1k-04- 1p---.:-V -)0•4'c'f.cA, T1 Telephone No.SO5 3(.p 50)(7 Owner's•Address 40 401( r q04/ \-1 . © ' Is this permit in conjunction with a building permit? Yes r'r,"-- No r.; it_'herk Appropriate Box) Purpose of Building l t)-e.11i41"1:5-" Utility Authorization No. _ - .1 Existing Services Amps ., / Volts Overhead Q Undgrd Q No.of Meters New Service Amps / Volts Overhead QUndgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical � Work; I1�'r k nLM1100(0-(Q �� O triO • Completion of the fallowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 No.of Cell.-Burp.(Paddle)Fans No.of Total - ansformers KVA No.of Luminaire Outlets No.of Hot Tab's Generators KVA No.of Luminaires Swimming Pool Above Q In- 0 Bao f E ne es►cy Lighting —' grad. grad. ry Unites No.of Receptacle Outlets 9 No of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2_ No.of Caws Burners No.of Detection and 1;-idating Devices No.of Ranges • N.: of Mr Cond. T ta No,of Alerting Devices No.of Waste Disposers t.np Number __.off_ _',__.. `c.n on Totals: Detectio+ Alerting Devices No.of Dishwashers Space/Area Heating KW . Local Q Monne�tiaunid aln Q Other C No.of Dryers Heating Appliances • KW Security S items:* g� No.of I1 viers or Equivalent • No.of Wateaters • No.of No.of Data Signs Ballasts Novicxa or Equivalent No.Hydromassage Bathtubs No.of Motors -Total HP TelecommunicationsofDevices rlquival No.of orEquiva ent OTHER: Attached additional detail of desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work 4 ZC- (When required by municipal policy.) Work to Start: 1 -FS`Z/ 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 Q BOND D OTHER (Specify:) I certify, under the pains and•enalties of perjury,that the information on • is application is true and complet - FIRM"NAME: G•C p - 4 c _ A r ,_ LIC.NO.: k Licensee: Qe,�,,A_ Cmoo\ -e, Sii� I _ gnature .r" LIC. NO.: (If applicable,enter"exempt"in the license nurnt.-z li:+e) r. / 'us.Tel.No.: *E614-\Lo l� Address: 2- i P 9 6\ ock-we 04 e 4-1,\ `C / IF ,1-04 AAS 1 lifft w ' 'SAIL Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have theliability insurance coverage normally required by law.By my signature below,IIereby waive this requirement:I am the(check one) Q owner Downer's agent .Owner/Agent SignatureI Telephone No. _ - 'PERMIT FEE:$