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Home My WebLink AboutBLDE-22-001955 Commonwealth of Official Use Only Permit No. BLDE-22-001955 . Massachusetts 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:10/5/2021 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) 22 BRADDOCK ST Owner or Tenant ROACH MARTIN D Telephone No. Owner's Address ROACH LESLEE H,22 BRADDOCK ST,SOUTH YARMOUTH, MA 02664 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: Wiring of 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 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 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 o Municipal ❑ 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 Siens No.of Devices or Eauivalent 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: Daniel 0 Wilkey Licensee: Daniel 0 Wilkey Signature LIC.NO.: 32288 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 CENTER ST,SOUTH DENNIS MA 026603744 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 (t4/z/ kg ,L «r2Z/ . R- c-td`'.. ` .. o - _� ConunvRweatih alMa ci > Official Use Only ly i''--T__°_rt Permit No. a2c (L _ :ia - n Apartment o re Serviced % +_ N .. -__►;'=5' Occupancy and Fee Checked �.. >4 y c BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) vw , Z' ' PLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Li(;W All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 SE PRINT IN INK OR TYPE ALL INFORMATION) Date: Oc(, C )(7 Cr a3 m City or Town of: y1�;i11oc:�-}-h, To the Inspector of Wires: y application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) aa V R ( " K 3}. lam"), ` A-T(110 o + k Owner or Tenant inaC-- 1 ' L Q A ch Telephone No. Owner's Address Is this permit in conjunction with a buildin permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Cy)L t-t'}jyl, I t11 tyC, Utility Authorization No. Existing Service ICC) Amps /21r/ ,4Q Volts J `Overhead ® Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity r Location and Nature of Proposed Electrical Work t i 06 O- 6A4. k )00,1 I - 0,1h L7'5+ 'FAN 4 I:,`.T And F z rx j- k:+ `� Completion of the followin: table may be waived by the Inspector of Wires. .ofTotal ,� KVA No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans TransformersNo KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above L. In- ❑ No.of Emergency Lighting grad. grnd. Battery Units Q'No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas BurnersInitiating Devices I YNo.of Ranges No.of Air Cond. Tons) No.of Alerting Devices 1'No.of Waste Dis rs Heat Pump Number Tons. KW No.of Self-Contained p� Totals: - Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mp ❑ Other Connection ->No.of Dryers Heating Appliances KW SecN of)devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent C4 No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wring. No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: If ''- (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 xi BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the informati n on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: n t�. �� Signatur ' LIC.NO.:'ZZ;>6-E Addrlicab nor" in tlle�litcens11 -e, lne ' ,�(� Bus.Tel.No. Address: ,j) L f4 V f"t Alt.Tel.No.•. 'Per M.G.L.c. 147,s.57-61,security work requires partment 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:$ 1,5-- 4