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Home My WebLink AboutBLDE-22-003404 kiik Commonwealth of Official Use Only i, `' Massachusetts Permit No. BLDE-22-003404 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:12/15/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notic f his or her intention tp r orm the ele,ctrical�work kddescribed below. Location(Street&Number) (0 < i t L.L (/J��'� `v Owner or Tenant GREGORY&JEA HAND EN Telephone No. Owner's Address _ .1►`' (141 6 Is this permit in conjunction with a building permit? Yes 0 No 0 (k , 2 Box A Purpose of Building Utility Authorization Existing Service Amps Volts Overhead 0 Undgrd a 1• i` New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ ter-nd. ❑ No.of Emergency Lighting grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No.of Switches Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local ❑ Connection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers pp No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Value of Electrical Work: (Whenq p p y') 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 R NICOLL Licensee: David R Nicoll Signature LIC.NO.: 37557 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 144 DRIFTWOOD LN,S YARMOUTH MA 026641038 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: $230.00 —; ,(L Qto 4/474 / IL4 (A r2.w a) 74.a-1 w - Gt1t *caodif 41(1:z ' 7 I ((IITi- 621 M Lk1 .' -, c Permit No. ��1.-z'34 c : _ _ �epartnwat of ire Jervicas �'f BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked -�� IRev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Elecuical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYP LL INFORMATION) Date: tEL- t 51 d k City or Town of: era .d J i }- To the Inspector of Wires: By this application the undersigned gives notice of his or h intention to perform the electrical work described below. Location(Street&Number) I y w'f Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes I No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service 1900 Amps kd'oia-Lto Volts Overhead 0 Undgrd[Z.- No.of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: `► - 5't D- P v 5 C LA) t API C NN 6-W )LA ELL(N ts� 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 gmodv.e ❑ glnrn-d❑ Naott ofy E mr[gency Lighting No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones nd No.of Switches No.of Gas Burners No.of Detection Initiating Devices es No.of Ranges No.of Air Cond. on No.of Alerting Devices No.of Waste Disposers Heat Pump_Ngmbcr_l__TRW:.__XW__ No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Cut neon 0 Other j • No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devi ces 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: 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 cov rage is in force,and has exhibited proof of same to the permit issuing office. 1 CHECK ONE: INSURANCE BOND 0 OTHERS , ' .) h i e_a A t, se Co fvtG 5 : I certify, under the p ikins and penalties of perjury,that the info ion on i'•• ' • • complete. FIRM NAME: >a tco ). � LIC.NO.: 3? S 57 e - Licensee: Signa It. J. (. r , LIC.NO.: (If applicable enter"exe t"in the license timber line.) Bus.Tel No.: b 39q"bZ 3( Address: tLI 4 bki PrwU t t Lh -C.-YitoUt h t Nik- d to Alt.Tel.No.:b C "3 0-73i3 tsiC t-U.) *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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) 0 owner ❑owner's agent. Owner/Agent ! Signature Telephone No. PERMIT FEE. $