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Home My WebLink AboutBLDE-22-003889 co v\ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003889 trl 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:1/12/2022 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) 37 ACRES AVE Owner or Tenant BARGSLEY LISA Telephone No. Owner's Address 12002 BLACK ANGUS RD,AUSTIN,TX 78727 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: Partial remodel of kitchen. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- . ❑ No.of Emergency Lighting grnd. grndBattery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiatinn Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Conne Municipalion ❑ Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Stens No.of Devices or Eauivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: ADAIR MARTINS ELECTRICAN LIC.NO. 55688 Licensee: Adair Martins Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: 5088156173 Address:215 Palomino Drive, Barnstable Ma 02630 *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 lthhat the t e Licenseeck one)ds not have❑the oliability in coverageowner'urance s ager normally required by law.But my signature below,I hereby waive this requirement. Owner/Agent PERMIT FEE: $75.00 Signature Telephone No. 12,CLAT at( 1(Iq (-1.2* -- tJ//11- q ( Z2 (4:34-091v) 9/7/ - , RECEIVE® • AN 12 2422 0 •,wealth o f Maeeachaestte Official Use Only 22 � 3`8gi 1t cc77 Permit No, -E.:—'1--' ,, , lNG ,y PHKTME 'artmant of ire Serviced � j v Occupancy and Fee Checked ` "'' ' • ' •FFIRE 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 0//f2./2.2 • City or Town of: YARMOUTH To the Inspector of Wires: fBy this application the undersigned gives notice of his or her intention to perform the electrical work described below. .. Location(Street&Number) 9-3- Picpe . a-J( e.s+ 1 moo-0144, M4- (226 9-3 Owner or Tenant Telephone No. (- \j Owner's Address ��eq 1 Is this permit in conjunction with a building permit? Yes Er---No ❑ (Check Appropriate Box) ___ Purpose n rp of Building 1'‘e.SC.Ven -f-al Utility Authorization No. co I Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters tNew Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters — Number of Feeders and Ampacity a r' Loc on end Nature of Proposed Electrical Work: 1941-hed tteiktddd` re- .J i At 1. 4-c ,,,i-4) .,, t L' Imo, k.A-yi um,/ e.is cis¢5' vi to Completion of thefollowingtable m be waived by the Inspector of Wires. 11; No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of j vial Transformers KVA Zt No.of Luminaire Outlets No.of Hot Tubs Generators KVA r�, t No.of Luminaires Swimmin pool Above In No.of Emergency Lighting g /rod. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of OU Burners FIRE ALARMS No.of Zones ~` No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self2ontained Totals: ''• Detection/Alertin Dev ces No.of Dishwashers Space/Area Heating KW Local❑ Municip Connectional ❑ °ther No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs 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 El ctrical Work: (When required by municipal policy.) Work to Start: 13 2-1 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 p ins an penalties of per wry,that the information on this application is true and complete. FIRM NAME) A0h^( Ma,{h is kJ c Lt et-rt LIC.NO.: 5562-0- ►3 Licensee:4a(A„(' /fl -A4 S 74- Signature M:4,1...„52 __ LIC.NO.: (If applicable,enter"ex mpt"in the cense nu ber line.) Bus.Tel.No.:RN 1$-6 t} Address: 100 Se- gCkasp 6Jc� a s�(,te ((�j,} 02.655 a 3 �( Alt.Tel.No.: *Per M.G.L.c. 147,s.57- ,securi 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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. ( PERMIT FEE:$