The URL can be used to link to this page

Home My WebLink AboutBLDE-23-001216 Commonwealth of Official Use Only it* ..\fit Massachusetts Permit No. BLDE-23-001216 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:9/6/2022 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) 13 BREWSTER RD Owner or Tenant PETER FORSTHUBER Telephone No. Owner's Address 13 BREWSTER RD,WEST YARMOUTH, MA 02673 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: Re-Bar grounding 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 SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting No.of Luminaires grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. Total No.of Alerting Devices No.of Ranges Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alerting Devices al Munici No.of Dishwashers Space/Area Heating KW Local 0 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 Signs 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.) Estimated 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 W SPRINGER LIC.NO.: 21170 Licensee: David W Springer Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 *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: $50.00I (Alt( J q v/ C RECEIVED SEP o s 202 _/ addatudaiid _Official Use Only ( �� - • "°"�r DING DEPAR 1 M T cc�-� Permit No.�----2,3 " ___ ?, &sent° iro Serwced '-+..it,I 1-- Occupancy and Fee Checked a., BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V All work to be performed in accordance with the Massachusetts Electrical Code( EC),527 CMR 12.00 c3 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: cl (e/ .Z- v City or Town of: W YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intentimi to perform the electrical work described below. N Location(Street&Number) 1{ .5 r 5'k( CO r--{ Owner or Tenant ' 'o f5k 1-\J ber Telephone No.$O L 3-1\ $y03 N c Owner's Address — Is this permit in conjunction with a building permit? Yes ❑ No LJ (Check Appropriate Box) 1 NI Purpose of Building d tu-c.A.1(r 3 Utility Authorization No. Existing Service Amps J/ Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters �" Number of Feeders and Ampadty \ni Location and Nature of Proposed Electrical Work: of t\a„N t do v0 t.‘0 k, Completion of the following table nuy be waived by the Inspector of Wires. '.xti No.of Total Q,: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA `R '=Z;t No.of Luminaire Outlets No.of Hot Tubs Generators KVA r~\ A No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Bette 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 1' No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Hat Pump Number Tons KW -No.of Self-Contained p Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ other• Con No.of Dryers Heating Appliances KW Security Systems:' i'Y No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring. No.H Y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of El ctrical Work: 57:O.1 (When required by municipal policy.) Work to Start: / V - Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a 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: �P(c t.5e.� E.`-e di (cc_ LIC.NO.: L 1\7 o A Licensee: Ou cb ` .. c;ryatti. Signature il -,c (lir ( 5LIC.NO.:`323`� q (If applicable,enter"exempt in the tiicense nu ber line.) r UQ Bus.Tel.No.• SU$ 3 4`i 0 \3 Address: 1 D ,:;r 5 CC. (.(\`› Alt.Tel.No.: *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 PERMIT FEE:$ Signature Telephone No.