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Home My WebLink AboutBLDE-21-005167 .l,� Commonwealth of Official Use Only Permit No. BLDE-21-005167 ,1 .V1 Massachusetts -- B 0 ARD -BARD 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:3/11/2021 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) 11 STUDLEY RD q 10 —3 02 't 2-174 Owner or Tenant Barry Davis Telephone No. Owner's Address 11 STUDLEY RD, SOUTH YARMOUTH, MA 02664-4237 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: Kitchen, laundry, &bedroom. 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- ❑ No.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 Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other: Connection 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 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: $75.00 VoLoil SI 424 2/27/V t)/?6d , ‘ t4n GRAD I,r/i6- 7 (-qv/ .'(/ Commonwea&o`maesach.uostaa Official Use Onl ,� - ,-r 2)W'i c� gips Permit No.1' —5(6 7 epartmeni e`..tire Services t;- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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 INFORMATION) Date: „2 f Z r3/z-i City or Town of: ,o„-4L Yotr,,,,I),)-4-1,-, 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) 1 6�-oci I e y cot Owner or Tenant l � Telephone No. �ckrrc,� l JaJ� S P 9-1O -30z.-7Z1ti Owner's Address -423 1-i,,rL.,`n c 14)rr,IL PA Ce,A-4. ii lI e tin A- 076 7 Is this permit in conjunction with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building Qe,S ct e.A.A,..-r.,..( Utility Authorization No. Existing Service MO Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service 4//A- Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 'J l„. 42 v. y h 4e.O,44 74 e oft PS, Completion of the followinktabk mg be waived by the Inspector of Wires. No.of Total � No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans Transformers KVA `1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ri In- ❑ No.of Emergency Lighting g &rod. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners bio. Detectionnand Initiating nDevicca No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons _KW No.of Self-Contained Totals: Detection/Aiertin Devtces No.of Dishwashers Space/Area Heating KW Local❑ Munidonnecpti�on 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W No.of Devices or Equivalent OTHER: Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical Work 1 ,0O (When required by municipal policy.) Work to Start:,3 ,I z i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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 pedury,that the information on this application is true 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. BY1ny-signature below,I hereby waive this requirement. I am the(check one)owner ❑owner's agent. Owner/Agent • Signature ems, Telephone No. 9 iO 3OZ-'Z t( PERMIT FEE:$