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Home My WebLink AboutBLDE-22-000729 ,A% Commonwealth of Ofor ficial Use Only Massachusetts Permit No. BLDE-22-000729 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:8/9/2021 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 c ibed belo` Location(Street&Number) 32 WINDING BROOK RD q38,5" Owner or Tenant David Weston Telephone No. Owner's Address 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: Relocate devices, add shower light, &upgrade receptacle to 20 amp. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 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 2 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent 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 Eauivalent 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 le4306,t, 8 (1 (u Ct1/441-L 1 PQ(.c j oaf IRoo5k or, �r t giblz l RE EIVED AUG 0 4 I `_" Commonwaa[th o`ffaeeacttiadsiie Official Use Only _ >ii :<1; c� cc�� nn Permit No. 1.�2�'�7 261 BUILDING UL �� n+ ( 2spartrnsnt of irs Servicse B ____—__ -_-` 1 i'Iv Occupancy and Fee Checked -N,„„_,o.; BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 s (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: $ I A. I -7,o 2 1 City or Town of: YARMOUTH To the Inspector bf Wires: v, By this application the undersigned gives notice of his or her intention to perform the electrical work described below. v Location(Street&Number) 32, VJ t d ,^5 13 c t,0 k Ra Owner or Tenant Da v t 4 \t•SQ 5 4c IN Telephone No. 86o S l 3 c13$S s� V Owner's Address JC TIN ocek. LIN 5 G u t h le.e m o v-I k W1 A Is this permit in conjunction with a building permit? Yes No 0 1 (Check Appropriate Box) JJ Purpose of Building Res r ci e e e Utility Authorization No. ( Existing Service I 0 0 Amps / Volts Overhead Et Undgrd❑ No.of Meters I . New Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters dNumber of Feeders and Ampadty Location and Nature of Proposed Electrical Work: K t 4-t cs Q„. -- (et oc A.Ve 0 0-1- 1 k.-S a ver-) 5 w 1 4-cLe S . 13a-111 room - Ue5cade 0u-1.1e4 20 A. A d 6 5howec tr`'j. + . R(2IOcc-k-e Su)++cher. Completion of thefollowingtable may be waived by the Inector of Wires. tb No.of Recessed Luminaires I No.of Cell.-Susp.(Paddle)Fans No fTotal AJ Transformers KVA VA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 2 No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices ll i No.of Ranges No.of Air Cond. Tons -. No.of Alerting Devices No.of Waste Disposers Heat Pump Number_Tons _._..KW No.of Self-Contained Totals: .__ Detection/AlertinggDevices No.of Dishwashers Space/Area Heating KW Local❑ l�Tunicipal Connection ❑ Other No.of Dryers Heating Appliances KW No. f Devics:* es or Equivalent No.of Water K.W No.of No.of Data Wiring: Heaters Sis 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.) q- Work to Start: 1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 apptkadon is true and complete, FIRM NAME: 1-(0 me o,J v.e( LIC.NO.: Licensee: Signature LIC.NO.: (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: *Per M.G.L.c. 147,s.57-61,securitywork Alt.Tel.No.: 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 la . y my ignatu a below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agen Signature Telephone No. C e 1 1 I PERMIT FEE:$ '75-MI '5 60 c13 61385