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Home My WebLink AboutBLDE-22-006483 ekvii/ Commonwealth of Official Use Only t. 4); Massachusetts Permit No. BLDE-22-006483 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:5/11/2022 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) 17 MOSS RD Owner or Tenant James Kennedy Telephone No. Owner's Address MA 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: Remodel kitchen, bedroom,&2 bathrooms. 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/Alertine 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 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 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 perjuty,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.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 V.QLN Jett C( 11 (1, it'.. _ 7 ' r'" \ _, MAY 10 2022:� a` lrommonwsa[th of i//amac iueatie Official Use Only DEP i\\,_ „ ft Buy„..Di ., ..o, c'� Z—��3 By 2sparimsni of i„Q Serwcse Permit No. '1I ry Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07 j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK t All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ‹5717/ 0City or Town of: YARMOUTH To the Ins or o -ir �— By this application the undersigned givt _ h intention to perform the electrical work described below. Location(Street&Number) /'7 VA 6..5 A j• Owner or Tenant 7 r�,N,.S %e.,,..,,,,,„,_„p�y= Owner's Address Telephone No. 14) Is this permit in conjunction with a building permit? yes / No El (Check Appropriate Box) t Purpose of Building Utility Authorization No. d) Existing Service Amps / Volts Overhead ElUnd Undgrd El No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: tl� —4- `13,-I &v Ody, ta., r �2 i �e�... ��Te ti.,r +3r &,„„,,,„:� vl °� Completion of the followingtable m be waived by the In vector of Wires. U. No.of Recessed Luminaires No.of Ceil.-Sns . No.off n,F p (Paddle)Fans Total 14 No.of Luminalre Outlets Transformers KVA No.of Hot Tubs Generators KVA ,t'' 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 'ice.of Detection and i No.of Ranges Initiatin Devices No.of Air Cond. on No.of Alerting Devices Tons eat ump um er ons o.o e - onta ne No.of Waste Disposers Totals: . No,of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ un cap No.of Dryers Connection ❑ Other rY Heating Appliances KW ecu ty ystems: o.oWater No.of Devices or E uivalent Heaters ' o'o o.o Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No'of Devices or E uivalent e ecommun ea ons r g OTHER: No,of Devices or E uivalent Estimated Value of Electrical Work: Attach additional detail i ed,or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) 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 BOND 0 OTHER 0 (Specify:) I certify,under the pains and pen ties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: _ LIC.NO.: �' .L Signature yy'�CC (If applicable enter"exempt"in the license number line.) LIC.NO.: � Address: S >n Bus.Tel.No.: �a ` Alt.TeL No.:�a-��2I - 3sati *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 n�- required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's a_ent. Owner/Agent Signature Telephone No. PERMIT FEE:$