HomeMy WebLinkAboutBLDE-21-004785 ;' Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-21-004785
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'2/24/2021
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) 9 MATTACHEE RD
Owner or Tenant HILL STEVEN E Telephone No.
Owner's Address HILL NANCY E&THORPE DAVID&JOANNE, 7 OLD STONEWALL RD, LAKEVILLE, MA 02347
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Apprq a [�
Purpose of Building Utility Authorization No. ''��OO��`' IN v+�•y
Existing Service Amps Volts Overhead 0 Undgrd 0 No.�T.,Me
New Service Amps Volts Overhead 0 Undgrd 0 No.of a er
to
Number of Feeders and Ampacity t
Location and Nature of Proposed Electrical Work: Remodel bathroom.
Completion of the following table may be waive •r ires.
:
No.of Recessed Luminaires 1 No.of Ceil.-Susp.(Paddle)Fans No.of t;
Transformers • '
No.of Luminaire Outlets No.of Hot Tubs Generators
No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 3 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 0 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 Data Wiring:
Heaters 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 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: David Bechtel
Licensee: David Bechtel Signature LIC.NO.: 16942
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: PO BOX 818, LAKEVILLE MA 023470818 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
signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $75.00
I4 IA 1 ( 0 : 24)4.41 L/A0
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Y • ,, Permit No. 2c- 7 5
-I. p Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) (leave blank)
k
1-1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in acconlaace with the Massachusetts Electrical Code(MEC),527 CMR 12.00
4 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
E City or Town of: Yee r rl ou 4 L To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
et Location(Street&Number) 9 /h q 1# 4 Cil e e ,z _
t„ Owner or Tenant 5 4 e V e IA. it I I Telephone No. See$-9 eid 4997
Z Owner's Address S'4/1 P
-} Isthis permit n conjunction with a
�, i building permit? Yes ET No 0 _ .(Check Appropriate Box)
Purpose of Building Re r1 o ore I:ti/ $q 4 4✓`oo fv. Utility Authorization No.
V
Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
to New Service Amps / Volts Overhead Q Undgrd 0 No.of Meters
t J Number of Feeders and Ampacity
-'0 Location and Nature of Proposed E trksl Work: 9.e r„,,6,,e l:,, g 2$'f' .'hoof (3,441.,rod M .
VI
Completion of thefollowinp table m be waived by the! of Wires.
tbNo.of No.of Recessed Luminaires / No.of Cel.-Snap.(Paddle)Fans Transformers KVAVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminairest f SwimmingPool Above In- .No.of Emergency Lighting
Brad. 0 grad. ❑ Battery Unit
No.of Receptacle Outlets Z No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 3 Na of Gas Burners Nor of Detection and
Initiating Devices
i ti No.of Ranges No.of Air Cond Tons Total No.of Alerting Devices
No.of Waste Disposers Heat Pump 1Tumf er Tons KW *0.of Self-Contained 1
Totals: ""_"" .M. ..._..r�_ Detection/Ale j�Devices
No.of Diahwashers Space/Area Heating If W L Mun
❑ Connection ❑
No.of Dryers Heating Appliances KW Security Systems*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or ' .ulvalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecomnrumcatlons ' ' s..
No.of Devlixs or Ea � ::.t
OTHER:
Sn 0 Attach additional detail if desired or as required by the Inspector of Wires.
Estimated Value of Electrical Work: s (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 0 BOND 0 OTHER 0 (Specify:)
I certffy,under the and of perjury,that the information on this application is true and complete
FIRM NAME: 4S F rs i;et I 5 ys-cr+ ,S r,(/e. LIC.NO.: /6 7 s A
Licensee: 1)c y e s e c h4 e L Signature ����.��` c/
(Iflkable„ens •' pt" n the 1% ber lieu, G�l�r� LTC.NO.:� b 6
Address: C IC � L4kev.`lie /n ad 3 y`) Bus.TeL No.: o - ®2
'Per M.G.L.c. 147,s F57-61,security work requires „ „ Hit.Tel.Na: S'oS- S'o9-,�`jp'
roqu Department of Public Safety S License: Lic No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee rides 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/Agentagent.
Signature Telephone No. I PERMIT FEE:$ I