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Home My WebLink AboutBLDE-21-006287 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-006287 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:4/30/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 7 WISTERIA RD Owner or Tenant Chris Boucher Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • • I r." Purpose of Building Utility Authorization No. 407 Existing Service Amps Volts Overhead 0 Undgrd 0 N'o. 1 4 e Q V New Service Amps Volts Overhead 0 Undgrd 0 s I ) ' Number of Feeders and Ampacity -i:/s.),&* Location and Nature of Proposed Electrical Work: Wall oven,cook top,washer&dryer installation. O �� Completion of the following table may be waive or of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of a Transformers IG�i/ No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4.1 No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Batter,Units `, No.of Receptacle Outlets 2 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 1 No.of Air Cond. Total No.of Alerting Devices Tons j 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 0 Municipal ❑ Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Eouivale p No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eauiv• ent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications iri•j: No.of Devices or E iv nt�0 OTHER: /�1 ,v Attach additional detail ifdesired, . ,s0A,+ 'ed by`th6Insecto o ' . • Estimated Value of Electrical Work: (When required by municipal policy.) 0,, ,, Work to start: Inspection to be requested in accordance with MEC Rule 10,and upon completion. C0 INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licens FA T provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The undersigned certifies that s N. . coverage is in force,and has exhibited proof of same to the permit issuing office. N 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: Sherwood E Lewis Licensee: Sherwood E Lewis Signature LIC.NO.: 11503 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:PO BOX 283,YARMOUTH PORT MA 026750283 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 E3 t`-6 44-I f7ii (kJ cf1) ( P441('Lt) V Commonweal o f///a ach.u�s Official Use Only i• � c� c7 Permit No. G;� - .2�7 -� ..Department opine Service6 L c 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 PE ALL INFORMATION) Date: I 2.q 2.6)2_i City or Town of: f lr/hd.Ai- p To the I Spector of Wires: By this application the undersigned gives notice of his or her intention to perform -0.,, electrical work described below. Location(Street&Number) C 7 Ve,„S}Prj 6 ea,, , west- 0.'0.B�` - /IMA_ 02471 Owner or Tenant Ch eiS $,u,cA e,- L Telephone No. Owner's Address 7(,✓iJ1-er'l4. gook/ mss` ye-,.,,,,„..f4.77)4. 0'2075 Is this permit in conjunction with a buildingpermit? Yes ❑ No n (Check Appropriate Box) Purpose of Building SN4,,ti e resl en C 4e- Utility Authorization No. Existing Service Amps / 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: JASP/116 t+,0" A WI if sot,.en,C.0/4-f/ fecepkde, t S Ck4k WCShtr' 4. Arv.4,' rece/OI�"Acle. . / Completion of the following table may be waived by the Inspector of Wires. otal No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No. InDeteand Initiatinnggon Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons 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❑ Municipal Connection ❑ Other No.of D ers Heating Appliances KW Security Systems:* rY No.of Devices or Equivalent No.of Water 'No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Equivalent No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: Lir 1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: 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 ® BOND 0 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.: trp✓m►L Licensee: Signature ;�,� LIC.NO.: r I�OOf (Iffapplicabl enter' empt"in the license number line.) Bus.Tel.No.:.s9"-29,-•9s,3 Address: Ie6S (P4' Per1/lr .3,i1'""4- 6'4gy Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,sec!rity wait 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)❑owner 0 owner's agent. Owner/Agent ( PERMIT FEE: $ Signature Telephone No.