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Home My WebLink AboutBLDE-21-005178 Commonwealth of Official Use Only ` .11% Massachusetts Permit No. BLDE-21-005178 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:3/12/2021 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) 74 WILFIN RD Owner or Tenant Lindsey Clark Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Approp t• Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ M w_ 1 / New Service Amps Volts Overhead 0 Undgrd 0 4�.o. l, •to /__ _ — Number of Feeders and Ampacity C q Location and Nature of Proposed Electrical Work: Misc,work per attached. n n `// Q 4 /v/ Completion of the following table may be waive �ct rf Wires. No.of Recessed Luminaires 3 No.of Ceil:Susp.(Paddle)Fans No.of20Transformers No.of Luminaire Outlets No.of Hot Tubs Generators No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 5 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. 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 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: Alfred B Watters Licensee: Alfred B Watters Signature LIC.NO.: 24033 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 LINCOLN VILLAGE RD, HARWICH PORT MA 026461601 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: $50.00 • Cnonrnwnweesltls/,� yy��r�� Official Use Only 0. • ', o`//lPermit No. C.;--- -t- 7' 9 (� U ; 2).partment o/ ServicedOccupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leve blank) APPLICATION FOR PERMIT TO PERFOR ELECTRICAL WORK All work to be performed in accordance with the Massachusetts (MEC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR 77'E ALL INFORMATION) Date: i 1/ )-� City or Town of: ��' 4/4,/ A, To the Inspector o iris: By this application the undersi gives notice of his ; er intention to perform the electrical work described below. Location(Street&Nu ,ber) 7 11 / r /Pce-- Owner or Tenant A .v,( 4 ,, t td_t 0 Telephone No.of 7 --77I-e95/0 Owner's Address fig = �4/ 4. i�i 4. �/?(a 7 Is this permit in conjnn on with a b permit? Yes ❑ No (Check Appropriate Box) Purpose of Building L,Qf!� n� Utility Authorization No. Existing Service //y() Amps /)j) / 19b Volts Overhead 1 Undgrd 0 No.of Meters / New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 71U.1.--C111421,/ a3a '3(,// l/.2. cam, l att& . add "Wog c%n, top�i44- -add iia d i v� _ vl Completion of the following table m be waived by the/ nspector of Wires. "' No.of Total 17, No.of Recessed Luminaires 3 No.of CeIl.-Sussp.(Paddle)Fans Transformers KVA (sr No.of Luminaire Outlets No.of Hot Tubs Generators KVA A.. No.of Luminaires Sw�immin Pool Above ❑ In- ❑ No.of Emergency Lighting g grad. grnd. Battery Units �! No.of Receptacle Outlets 5 No.of Oil Burners FIRE ALARMS No.of Zones of .. No.of Switches ,j No.of Gas Burners 4o.Initiating tion and "T l':.' 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/Aler Devlces No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other 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 Telecommunicationsofor Equivalent No.of Devices Equivalent OTHER: Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value f ectrical Work:3/�,4.0 — (When required by municipal policy.) Work to Start:2) ii at 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 cove is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certffy,kinder tifai - and penalties ofperjury,that the info - . on this application is true and complete FIRM NAME:( - 'i (� LIC.NO.: r✓4433 Licensee:J C i W/)1-f Signatu :l1I A,/ i._/ LIC.NO.: E--.2V6,3' (If applicabl.,entq� %�exem t"7'n/th_e license ber line.) Bus.TeL No.• '('' Address:f /IGitP. VCLi . �iY0.Luuo 02Z/VC( �t C& Att.TeL No.: *Per M.G.L.c. 147,s.57-61,secuty 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. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$