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Home My WebLink AboutBLDE-23-000555 — Commonwealth of Official Use Only r ►, � t Massachusetts Permit No. BLDE-23-000555 € ► 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:8/3/2022 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) 30 ASTOR WAY Owner or Tenant CHRISTINE SLACK Telephone No. Owner's Address 30 ASTOR WAY, SOUTH YARMOUTH, MA 02664 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Emergency repairs to meter socket. 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 Initiatine 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/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: David M Hawkins Licensee: David M Hawkins Signature LIC.NO.: 31112 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN,YARMOUTH PORT MA 026752252 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:$50.00 .k7i, c 0-(Rs 3(7>v t 1- Commonwealth oI I1laeeacnueelte Official Use Only Permit No. t23-0 S-9 2spartnnent o/.lrs Serviced 1 r : - 4 BOARD OF FIRE PREVENTION REGULATIONS (Rev. I/O cy and Fee Checked T) (leave blank) h APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( C),5 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ./� '— I City or Town of: [„ - To the Ins lector of Wires: 4 By this application the undersigndd gives notice of his or her intention to perform the electrical work described below. Location(Street&Number)NAI `2 � ILA-4 Owner or Tenant ( 4I11 S'a A.-- 4 t Telephone No. 41, Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization o. Existing Service /CO Amps j 20 /al 96 Volts Overhead El Undgrd[ No.of Meters i New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: g F tiq y J- /W A' ® ETE P SOO J Completion alike following table m be waived by the Inspector of Wires. 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 SwimmingPool Above ❑ In- ❑ No.of Unitstmergency Lighting t rn& grad. 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 Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste DisposersHeat Pump Number'Tons KW No.of Self-Contained Totals: Detection/Al- , Devices No.of Dishwashers Space/Area Heating KW Local 0 CoMunidnnection 0 Ott, No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications q No.of Devices or Equivalent OTHER: ,�/ t Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work! 300 t (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 coy a.::e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE T BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: 4i/.Lt; �2), Ign 1 f"""' S ature �►,�- LIC.NO.: _... 120 (If applicab e,enter.exempt"in the license number tine.) �/,, o6 Bus.Tel.No.` Address: 1 C/ unity 3i tin iv�,s,i 1,0. J fi' 0 i3 A Alt,Tel.No.: *Per M.G.L.c. 147,s.57-61,security w requires pertinent 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:$ .r,