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Home My WebLink AboutBLDE-22-006955 Commonwealth of Official Use Only ff_ Massachusetts Permit No. BLDE-22-006955 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:6/2/2022 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) 14 WEBSTER RD Owner or Tenant GODIN DAVID Telephone No. Owner's Address GODIN HILARY, 185 NORTH MAIN ST, SUFFIELD, CT 06078 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 ❑ 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 bathroom Completion of the,following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 2 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 PoolAbove ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tonal 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 ❑ 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 ❑ (Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: Shawn'A Souza Licensee: Shawn A Souza Signature LIC.NO.: 39768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 LAKE DR, PLYMOUTH MA 023605648 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 /l)72- 7(t /vv . 71-Cctokjr Toujh RECEIVED JUN 0 + Logoawes a o`Vaeeac (fe Official Use Only j!,, '' c� ,,,,�,,-_F Permit No.e-2Z ( q Sr; B U I L D I tV G Dk .R7 T �lJe ./.7i,..&mi., By --—- --- ..,i: --- :OARD OF FIRE PREVENTION REGULATIONS Occupancy] (I Fee Checked . [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Coda M1 ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: G�/( p.p._ City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives-nod-de ofhis or her intention to perform the electrical work described below. Location(Street&Number) l'i GO c4 SF-c&. 2 J Owner or Tenant 1c)t>1/4.0 'J G-0 l sl) Telephone No. Owner's Address S OM,L.- L this permit in conjunction with a ‘ i permit? Yet No ❑ (Check Approp a Bos) • Purpose of Building ' 1\iJcj� . / `"/ 4 r Utfty orizadon No. /v ' Existing Service/00. Amps /0)4/v2IOVolts Overh Undgrd❑ No.of Meters i New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampadty Location and Nature �Qifrropoaed Electrical Work: W /L.tr p l•- 02 &n_t'� 21t0�\ is J Completion of thefollowtngtable me be waived by the&vector of Wires. W No.of Recessed Luminaires �— No.of Cell.-Sasp.(Paddle)Fans No.of 'Total (24Transformers KVA n • No.of Luminaire Outlets No.of Hot Tubs Generators KVA -t. No.of Luminaires gig p� Above ❑ In- ❑ Ivo.of Emergency Lighting Wild. tired. 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 IV No.of Ranges No.oI Air Cond. •Tons No.of Alerting Devices otai , Na of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: ."_ _.:.�.._ ��...__..__.. Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Moa Connection � �' No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Waterte , No.of No.of Data Wiring: HSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Devicr =tet Eq OTHER: Attach additional detail if desired,oras required by the Inspector of Wires. Estimated Value of 1 Work: /Sd C� (When required by municipal policy.) Work to Start: / oZ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE VERAGE: Unless waiv-. . the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability' • ,ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coy-, a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE IP BOND 0 OTHER 0 (Specify:) I carlify,under the , and pe ,, ofpe.dry,that the information on this n is true and complete FIRM NAME• _ , , ei,_ f , /`lid ,� LIC.NO.: 9 Lkxasee: S(,, N — 120.--- Sig�natu . .._...._ LIC.NO. s (If applicable�yer 2 the li J tbe�line.)/p� Q.s r, Bus.TeL No.• t1lriir 0 -'y�7 P Address: �! t'tk /44- claCiAlt.TeL No.: 'Per M.G.L.c. 147,s.57-61,security work requires De srMient 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. 1 am the(check one)❑owner 0 owner's agent. Owner/Agent I Signature Telephone No. (PERMIT FEE:$ "S"--