The URL can be used to link to this page

Home My WebLink AboutBLDE-21-005164 Commonwealth of Official Use Only Or° Massachusetts Permit No. BLDE-21-005164 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 1Rev.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) 136 WIMBLEDON DR Owner or Tenant Richard Hill Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriat•` ` JIL re Purpose of Building Utility Authorization No. (� Existing Service Amps Volts Overhead 0 Undgrd 0 N 1 I % e New Service Amps Volts Overhead 0 Undgrd 0 No.o s GIA • IV/� office Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Finish area of basement for &exercise area. ? Completion of the following table may be waived by the , .v fres. : No.of Recessed Luminaires 15 No.of Ceil.-Susp.(Paddle)Fans No.of To • D Transformers KVA No.of Luminaire Outlets 3 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- 13No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 17 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiatine 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 Siens 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: GARY W BAKER Licensee: Gary W Baker Signature LIC.NO.: 30456 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 18 BEECHWOOD RD, BELLINGHAM MA 020191125 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 f a--v--4,6 5( J 21 k -. Commonweal tt Of 2aiiacIiusa1f Official Use Only y m Permit No. _Y , Deparlmenf of Jire�ervices :3,��,o BOARD OF FIRE PREVENTION REGULATIONS [ Occupancy e . 0and Fee Checked (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: ,3/k) „;).( City or Town of: yarM n - To the Inspect r of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) /3 (J giblAr) ,Dr Owner or Tenant RJ re. --- / 1'0 Telephone No. ca.-.s?(c,S"- 2q6) Owner's Address is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 5:, ip ri .,�')t (y 3),1o,/10? Utility Authorization No. Existing Service Ymps / 1 Volts 'Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r a 111. , �� . ,_ r h • i C e) (.ompletion of the lollowingtable may be waived by the Incc,ertor of il'ires. No.of Recessed Luminaires /S No.of Ceil.-Susp. Traa ns(Paddle)Fans ToTotnsformers KVA No.of Luminaire Outlets 3 No.of Hot Tubs Generators KVA No.of luminaires swimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets f ( No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches S No.of Gas Burners No. Initiatinnggon Deteand InDevices No.of Ranges No.of Air Cond. Total g Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 7-1 Municipal Connection ❑ Other No.of Dryers Heating Appliances KWfiecurity Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: .mach additional detail if desired. or as required be the Inspector of Wires Estimated Value of Electrical Work: /,_,2e)O.O0 (When required by municipal policy.) Work to Start: 3)/01(2( inspections to he requested in accordance with MEC Rule 10.and upon completion. INSURANCE COVEAGE: 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`D BOND ❑ OTHER ❑ (Specify) I certify,under the pains and penalties of perjury.that the information on this application is true and complete. FiRM NAME: LIC.NO.: Licensee: ((C (,3, 6�,I�/ Signaturey.� 016 jZ� LIC.NO.:C.30.4570 III applicable'. enter empt''inj�the license number litre.) u Bus.Tel.No.:Sb q/$3 Address: / 6 ,i fQOCjV2' rd ' (�i� t m ft-Od lc( Alt.Tel.No.: *Per M.G.L. c. 147.s. 57-61.security work requires epa ent of Public Safety"S" License: Lie.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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $