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Home My WebLink AboutBLDE-21-005133 a Commonwealth of Official Use Only 41%, ! Massachusetts Permit No. BLDE-21-005133 ''" • 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:3/11/2021 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) 227 WOOD RD Owner or Tenant WHITTEMORE ERIN M Telephone No. Owner's Address 227 WOOD ROAD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App i • * '6/ ' r Purpose of Building Utility Authorization No. L/ Existing Service Amps Volts Overhead 0 Undgrd 0 :Iv;f i t a Acal — New Service Amps Volts Overhead 0 Undgrd 0 No.o t Number of Feeders and Ampacity 4")",),�� Location and Nature of Proposed Electrical Work: Wiring for bedroom addition. 4V,42 !, Completion of the following table may be waived by t .. •-Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of , Transformers 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 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 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWMunici al Local ❑ Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Siens Ballasts No.of Devics 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: Licensee: John Weiss Signature LIC.NO.: 22602 (If applicable,enter"exempt"in the license number line.) Address:63 Uncle Bobs Wy, South Dennis Ma 02660 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 thecheck one ❑ Owner/Agent ( owner 0 owner's agent. Signature Telephone No. - PERMIT FEE:$140.00 ;.,cif 310-u td 24I-21 vz (2ead Y I=�� s �� oa h ,7is ci to-4 L- L,p�P.� Coil.1 official Use Only 1 ' .�[�pari nwnfi /Tim Permit No. C-.-.."7--k "S 3 3 • BOARD OF FIRE PREVENTION REGULATIONSand 's [Rev. Il07] (leaveFeeblank) ked APPLICATION FOR PERMIT TO PERFORM ELECT ICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( ,5 CMR 12.00 A (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ) / eo Z/ City or Town of: 5I.r# nc-s To the I c r of Wires: By this application the undersigned gives notice of liis or her.e I A$ to perform the electrical work described below. Location(Street&Number) ,22 2 C /' "/ S„ ( ,„ e l"Zj Owner or Tenant '/,I,j je`✓, ,t2 /._4 f fj 44'1 Telephone No. 5e-re-T-1.1?..r-77 -� Owner's Address 27 2 �C: 129 -c,0 Is this permit in conjunction with a building permit? Yes IN No 0 (Check Appropriate Box) 4 Purpose of Building k�� Utility Authorization No. Existing Service C( Amps IZO/ e etiVolts Overhead 0 Undgrd 0 No.of Meters t New Service Amps ! Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: "rye c.„ " c ' /3ec//.,./7-i V�1 Completion of the following table my be waived by the I or of Wires. No.of Recessed Luminaires No.of Ceil.-Snp.(Paddle)Fans Transsformers KVA odi S. No.of Luminaire Outlets No.of Hot Tubs Generators KVA k No.of Luminaires S��g pOH ❑ Ind. ❑ Ivo.of,Units Ltgtit�ng > Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 'No.ofInitiating n$n a �` No.of Gas Burners ' Ili No.of Ranges No.of Air Cond. Ton Devices .No.of Alerting Device No.of Waste Disposers Totals: Pump Number Tons_ ,KW No.of Self-Contained Totals: ___ Detection/A a Device No.of Dishwashers Space/Area HeatingKW Mu� I'o�❑ Connection ❑ Other No.of Dryers Heating Appliance Seca S • No.of Water KW Na of or Equivalent Heaters KW No.Signs No.of Bts Data No.oWiring:evices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wu No.of Devices or Equivalent OTHER: 4/ Attach ada5tional detail Vdesired or asthe Estimated Value of Work: (/' required by Inspector of Wires. .2� (When''eq"ired by municipal policy.) Work to Start: a Inspecti• to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE GE: Unless waived by the owner,no permit for the the licensee provides proof of liability insurance including"completed performance of electrical work may issue The undersigned certifies that such coverage is in force,and has exhibitedsame to theon" e or its isssuing of equivalent The CHECK ONE: INSURANCEproofpermit tasting office. I�f}',under the pains and �' BOND 0 OTHER 0 (Specify:) FIRM NAME: pe, ies ofp�'ny', the information on this application is true and completes Licensee: LIC-NO.: 2Z('(�2/� Lice t sf Signature , ` LIC•NO.: (If applicable,enter" no".br license member lute.) Bus.TeL No.-' ' 3!moi d�9 Address: S g �L r/ n /2, l]OIr� G O""2C Q G' Alt,Tel. o..: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner owner's Owner/Agent ❑ ' agent Signature Telephone No. I PERMIT FEE:$