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Home My WebLink AboutBLDE-21-003383 _ ,,� Commonwealth of Official Use Only �:,.,,j� Massachusetts Permit No. BLDE-21-003383 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:12/15/2020 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) 26 MOLLY RD d Owner or Tenant DIAS JENNIFER N Telepho A\ Owner's Address 26 MOLLY RD,WEST YARMOUTH, MA 02673 Nip ~ , Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec - , I rob, Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of 1 ' 0 _ ' New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete - Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Water heater,dryer&washer receptacles, &replacement GFCI receptacle. 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- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 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 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 ❑ Municipal ❑ Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water 1 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:) qo�1 r� I certify,under the pains and penalties of perjury,that the information on this application is true and complete. v' f 7 Cz 27 FIRM NAME: MARK B KIEFER Licensee: Mark B Kiefer Signature LIC.NO.: 26093 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 GRASSY POND DR, DENNIS MA 026382515 *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 signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No.�� nn (PERMIT FEE: $75.00 I "-1 1 K OM) &/ � �t — N7, — 1/3)7 0 _ l (e( c V' CIO r Commonw Official Use Only J. aerviced .�. . $ �G.J r �.re Permit No. e - 33 Et)5 Bt�ARO OF FIRE PREV NTq Occupancy and Fee Checked .' ON REGULATIONS [Rev. 1/07j (leave blank) .-. -. -APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ail work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 \f1 (PLEASE PRINT IN INK OR TYPE ALL INFORMA ON) Date: / _/d • dO 9,�V e City or Town of: r/c al e v it To the Inspector ofWires: 1 By this application the undersignefi gives notice of his or her intention to perform the elP .4,4. 9./ Location(Street&Number) (o 12)0 ✓ work described below, Owner or Tenant Jp Al Ali `1-t'4 Owner's Address S.A, i L R,� Telephone No. 1 Is this permit in conjunction with a building permit? Yes x No tt�--77 (Check Appropriate Boa) Purpose of Building t_.! Utility Authorization No. Existing Service Amps / Volts Overhead 0 UndgrdNew Service Amps 0 No.of Meters � Amps / Volts Overhead 0 Undgrd 0 No.of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /�.� � /h1 � �� 'k i � �' "�� 3 d dui, �(�i F✓c:. N t ice(L i� ,1 /1N -ti� LA./4 ( -tie„1- Completion oft a lowm&t ble,n t e„ i�r by the!vector of JI:res. No.of Recessed Ltuaine free No.of Ceti.-Snap.(Paddle)Fans No.of Total No.of Lumbnatre Outlets No. KVANo.of Hot Tab: Generators KVA No.of Laminslrea Swimming p.m Above wino In- No.of Emergency Lighting `� No.of Receptacle Outlets � No.of end' Srnd � Battery Units 011 Burners FIRE ALARMS INo.of Zones No.of Switches No.of Detection and No.of Gas Burners Inidating 1° No.of Total Devices Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons )KW 'No.of Self-Contained Totals: I _..__.__.T_._ Detection/Ale Devices No.of Dishwashers Space/Area Heating KW Local 0 Man�ai No.of Connection 0 f�` Dryer Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters...n ' No.of Data W Signs Ballasts No.of Devices or ulvalent ,. No.Hydromassage Bathtubs No.of Motors Total HP TeJecommun1ea>iona , : OTHER: No.of Devices or Eguty tit c). Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to Star#;/o� -/U � (��required by municipal policy.) a2 l7Inspections to be requested in accordance with MEC Rule 10,andupon INSURANCE COVERAGE: Unless waived by the owner,nocompletion.kass y� the licensee providespermit for the performance of electrical work may issue unless 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 CHECK ONE: INSURANCE L] BOND 0 OTHER permit issuing office. `- I cee uijy,under the pains and0 (Specify:} FIRM NAME: penaMes of, �,ury,that information on this application is true and complete_ Cr Licensee: / t " =� 'Ak LIC.NO.: Lfaensee:le,enterlthe �num Me.) Signature �� LIC.NO.: Address: SS Bus.TeL No.: *Per M.G.L.c. 147,s.57-61, tyres S Alt.TeL No.se: Lic.No.: OWNER'S INSURANCE WAIVER.: I am aware that censeeDepartment ofedoes blic note the liability ityy insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one ■ owner ■ owner's ::ent. Owner/Agent , Signature Telephone No. PERMIT FEE:$ ?5