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Home My WebLink AboutBLDE-23-000672 Commonwealth of Official Use Only '' Massachusetts Permit No. BLDE-23-000672 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:8/9/2022 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) 19 INDEPENDENCE RD Owner or Tenant Matthew Hughes Telephone No. Owner's Address 19 INDEPENDENCE RD,WEST YARMOUTH, MA 02673-1515 Is this permit in conjunction with a building permit? Yes ❑ 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: Permit for final inspection for expired permit#BLDE-21-005609. 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- IDNo.of Emergency Lighting gzrnd. 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 I Number I Tons l KW_ No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent 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: OTHER: No.of Devices or Equivalent 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 I certify,under the pains and penalties o.fperjury, that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: Address: Bus.Tel.No.: *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 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 fZeiC C.r e 11 019 4/ le-f__ CA424. 64,04- G c i i �J 6: kf q/i t V1, Ca t 324 7fr / -.* --`i\ 91/ 2/VZ- 14 Conunoniveaah el Maseachadelis Official Use Only ,1 Aparbnad of[gins Sawkw Permit No. '`::�,. _ % r' BOARD OF FIRE PREVENTION REGULATIONS • Occupancy and Fee Checked ' V. 1/07j leave blank --- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W ORK •, All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 rr (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOM Date: C d i. City or Town of: YARMOUTH To the Inspector of Wires: tw. Location(Street&Number) ^n BY this application the undersigned gives not afbis or her intention to C perform the electrical work described below. . Owner or Tenant l f-y,e H, } ,9 e5 Owner's Address ol `41e e^dry ce Telephone No.,t' -02 i 7-Qboa ( thi s permit in conjunction with a building is se of Building permit? Yes No 0 (Check Box) • �ti c c n+c woo s<e f Appropriate Utility Aothorizatton No. c' Existing Service Amps / Volts Overhead s 0 Undgrd 0Na of Meters — Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampachy ❑ No.of Meters Location and Nature of Proposed Electrical Work: �. ' ,, l; ►i,,, �e t g,se vKt�►~f �dtd e d ov+ le s a C, ,lefion o the ollowin_ table m, be waived, the I , L No.of Recessed Luminaires No.of Can.-Snap.(Paddle)Fana "o.o u for o Wires. Na of Luminaire Outlets Transformers KVA Na of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool ,, ' dve an� .0.o 'mergency ';/. ;ng � No.of Receptacle Outlets No.of Oil Burners �d. a Bette Units No.of Switches No.of Zones No.of Gas Burners o•o Pin- ;on a. , 1>r12=1111111.... Inhiatin Devices 4. No. , Mr Cond. °' Na of Alerting Na of Waste Tons Devices Totals: .'_up,. r ens �+ 'o.o ' r onrtn. Na of Dishwashers Space/Area Heating ._. Detection/Ale s Devices Na of Dryers KW I'0cei❑ Connection ❑ Othp• rHeating Appliances KW a,,.: o.o Na of 0 evices or ' ,uivalent Heaters KW o.o `o,o Na H tiro S -1,s Ballasts DataWiring: o y massage Bathtubs No.of Motors a omm M;Has ,;uivalent Total HP Na of ns r"" OTHER: Devices or ' ,uiv •-nt Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: m Work to Start en 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" undersigned certifies that such coverage is in force,and has exhibited roo fosamet coverageth or its substantial equivalent The CHECK ONE: INSURANCE 0 BONDproof of to the permit issuing office. f�.11',under the 0 OTHER 0 (Specify:) • FIRM NAME: Pains and penalties ofper)ary,that the Information on this application Is trite and complete Licensee: LIC.NO.: ----- (if applicable.enter"trempr"i cthe li cense number line.) Suture LIC.NO.:Address: `Per M.G.L.c. 147,s.57-61 Bus.TeL No.: security work requires�epsrtrnont of Public Safety,"S"License: Alt.TeL No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability required by law. Bymysignature Lic.No. Owner/Agentgnat gnature below,I hereby waive this i insurance coverage nvr�mal yI requirement. I am the(check one III owner MI owner's ::ont. Telephone No. PERMIT FEE:a s