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Home My WebLink AboutBLDE-22-000267 tp,'� Commonwealth of Official Use Only > �• Massachusetts Permit No. BLDE-22-000267 • 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:7/16/2021 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) 18 CARRIAGE LN Owner or Tenant Brian Dunton Telephone No. Owner's Address 18 CARRIAGE LN, YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel kitchen 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 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 ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent 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 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 J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 my signature below,I hereby waive this requirement.I am the(check one)) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$50.00 I Qv2,044,.i .,ti to/s174 r. c 14* # W2 •1 (A) ? ( 1. Ca-le. : CEIVEDD JUL 15r .� AA`� commonwaa[th o y1, „ `i//aaaac�Cua�ffa Official Use Only - 1if ;j c� cc77 n Permit No. �p7 BUILDING DE{:' - .fj; .>fFT �spart`nuntta�J`ira J 2' Serviced By — __ / OARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked "�. [Rev. 1/07] "'--- (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK iI All work to be performed in accordance with the Massachusetts Electrical Code( C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) SDate: 7 jCity or Town of: YARMOUTH To the Ins �ector of By this application the undersigned gives notice of hikor her intention to performthe aectical wok described below. Location(Street&Number) /ZdZ, 1 r G e t„ Owner or Tenant '• `t Te v� Telephone No. "h. Owner's Address `� Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) kNjPurpose of Building Utility Authorization No. 0 Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters A New Service Amps / Volts Overhead 4' Number of Feeders and Ampacity 0 Undgrd E] No.of Meters i A1 Location and Nature of Proposed Electrical Work: 1 N � . 1 v, vo Com letion o the ollowin table m be waived b the In ector o Wires. tl No.of Recessed Luminaires l:S No.of Celnsp.(Paddle)Fans o.o ota ':R No.of Luminaire Outlets Transformers KVA �=`ti No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool rode ❑ n o.o mergency g n nd. ❑ Bane Units g No.of Receptacle Outlets No.of Oii Burners �: FIRE ALARMS No.of Zones " No.of Switches No.of Gas Burners o.o etec on an E` No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers eat ump um er ons Totals: o.o e onta ne No.of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ Cun cipa ❑ OtterNo.of Dryers Heating Appliances KW ecu ty yst ms ion o.o a er o o No.of Devices or E uivalent Heaters KW o•o Data Wiring: Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors a ecommun ca ons r g Total HP OTHER: No.of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) INSURANCE COVERAGE: Unle sInspwai waived by ections to the owner,no permit e requested in for the performance of ce with MEC Rule electtri and l work aytiss the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The may issue unless undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the pains and pena ties ofperjury,that the Information on this application is true and complete. FIRM NAME: Licensee: � l gnature LI O.: ,. � i 7�- C.N f press: le enter xempt in the rcense nu ber line.) LIC.NO.:� ��_� 5 ,, Address: C *Per M.G.L.c. 147,s.57-61,security work requires De 4 7 +� Bus.Tel No.: INSURANCE WAIVER: I Department of Public Safety"S"License: Alt.Tel.No.:. e�XX 6a j OWNER'Sed by law.IN Bymysignatuream aware that the Licensee does not have the liability insurance coverage normally requirOwner/Agent below,I hereby waive this requirement. I am the(check one Signature II owner ■ owner's a,ent. Telephone No. PERMIT FEE: $ 51f).ot)