HomeMy WebLinkAboutBLDE-22-006890 Commonwealth of Official Use Only
Massachusetts
Permit No. BLDE-22-006890
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
IRev.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:5/30/2022
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) 9 TAM-O-SHANTER WAY
Owner or Tenant Phill Redfearn Telephone No.
Owner's Address 9 TAM-O-SHANTER WAY, SOUTH YARMOUTH, MA 02664
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 ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Sunroom addition
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 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: DAVID W SPRINGER
Licensee: David W Springer Signature LIC.NO.: 21170
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:70 Bishops Ter, Hyannis MA 026012106 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
iJ
34P" (16
RECEIVED
_.. ea�4///aaaacftiae4fa Official Use Onl
. :'/MAY 2 6 2021 �h�.w Permit No. -7i7i(�0
1:ILDIEINikits460WERIE PREVENTION R Occupancy and Fee Checked
REGULATIONS [Rev. lro7] (leave blank)
fi 'y _------
'T
) 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: 7 J2-4 I ZZ
g City or Town of: S YARMOUTH To the Inspector of Wires:
a- By this application the undersigns nonce oil is of herintentionto perform the electrical work described below.
V Location(Street&Number) 9 --\---04-\ 0 .5}1pki\{{,('
CI) Owner or Tenant Vti1;Ile _et, e..r-t\ Telephone No.57!g 1 7 F 1440
NJ
Owner's Address
7-4
N Is this permit in conjunciion with a building permit? Yes No ❑ (Check Appropriate Box)
r Purpose of Building 0eKVl Utility Authorization No.
N Existing Service Amps / Volta Overhead❑ Undgrd 0 No.of Meters
e New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampaclty
Location and Nature of Proposed Electrical Work: • u-n cod M Ne) ,-2 r\
m,
Completion of the followinttable my be waived by the Invector of Wires.
tit No.of Recessed Luminaires No.of CeiTran
of(Paddle)Fans Transformers Ki VA
KVA
;