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Home My WebLink AboutBLDE-21-004687 � Commonwealth of Official Use Only ,� I Massachusetts Permit No. BLDE-21-004687 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:2/18/2021 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) 28 GARDINER LN Owner or Tenant BLAIR JAMES T Telephone No. Owner's Address BLAIR LUANN, 135 SUTTON ST, NORTHBRIDGE, MA 01534 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 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 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 No.of Devices or Equivalent HeatersWater KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent (No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 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 ofperjury,that the information on this application is true and complete. FIRM NAME: DANIEL 0 WILKEY Licensee: Daniel 0 Wilkey Signature LIl. NO.: 32288 (If applicable,enter"exempt"in the license number line.) 168 CENTER ST, SOUTH DENNIS MA 026603744 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I I PERMIT FEE: $75.00 IJI/4 2f z 2-% ( ii rAdy F . l ts; 2D2 t Cofi.�,�, mmonwealrh o/I//addachadatid Official Use Only 1B e= ,� c-� c-� Permit No. V Zt —`-T(Q erns 2epartment o�.}ira Saruiced 7 cif; i Occupancy and Fee Checked t,.� BOARD OF FIRE PREVENTION REGULATIONS ' [Rev. 1/07] (leave blank) t APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Mascarhusetts Electrical Code MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Feb J 7 A I City or Town of: Yq c m Q%AA., 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) P43 Lr C a i t,TX L n. 30. Y AT M O O A-k Owner or Tenant 5c m 5 A;S'(..ti Telephone No. Owner's Address 135 SU I-v0(1_ Q . /UISn"01‘kAse:145' 9 1.r) . 01J3t.{ Is this permit in conjunction with a building permit? Yes gl No 0 (Check Appropriate Box) Purpose of Building orli, t am r ty eTht.)t I'1 i Utility Authorization No. / Existing Service IOn Amps o /ayn Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 143.1 Irt1, 11. cc CQ)EM0AC A J 4_ V R4\ r)om Completion of thefollowingtable may be waived lv the Inspector of Wires. No.of Recessed Luminaires No.of Cell-Sasp.(Paddle)Fans No.of otal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting g grad. ❑ grad. ❑ Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches a No.of Gas Burners -No.Or Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons ]KW No.of Self-Contain T Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ C Muonnicipal nection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W No.of Devices or Equiv eat OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: '50 (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE El 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: LIC.NO.: Licensee: I Signatu LIC.NO.:3 cWE E (If applico enter"e mpt"in the lice se n her ine.) Address: 0` Bus.Tel.No. *Per M.G.L.c. 147,s.57-61,security work require Department of Public Safety"S"License: Alt 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE:$