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Home My WebLink AboutBLDE-22-004806 Commonwealth of Official Use Only 4) Massachusetts Permit No. BLDE-22-004806 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:3/1/2022 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) 11 APACHE DR Owner or Tenant Dan Hunhardt Telephone No. Owner's Address 11 APACHE DR,YARMOUTH PORT, MA 02675-2103 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 ❑ 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: Remodel bathroom 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 Init Inito.of iating es andection No.of Ranges No.of Air Cond. Total oot l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p 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 Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Eauivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR, S YARMOUTH MA 026641339 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: $75.00 I fraA,Cek Y3(la GNP /P 2-4 9/771 RECEIVED -...it', MAR 012022 �[�j / ,la 7 ii/aaachedie Official Use Only i- `. °/ILDI-N UNA -fet_eNT Penult No.( �- . ' �T; 4 Aiwa ni of d,�...)ervtcse (� Occupancy and Fee Checked `p.� ; BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07) (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK i 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: /J ,I �Z @.> 1 City or Town of: YARMOUTH To the Inspector.of Wires: �Sy this application the undersigned gives notice of hi or her intention to perform the electrical work described below. &tj Location(Street&Number) 1/ 4 10 4 c, 6 v,,e Owner or Tenant D IA) - re., H U"I A, frel,P rit Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. ¶xisting Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters ii Number of Feeders and Ampacity II-- ). Location and Nature of Proposed Electrical Work: 12, .O>n d..) '+ Completion of thefollowingtable may be waived by the Inspector of Wires. tb l io.of Recessed Luminaires No.of ►fie Na of Cell.-Sualt.(Paddle)Fans Transformers Total No.of Luminaire Outlets No.of Hot Tubs KVA .. Generators KVA A' No.of Luminaires Swimming Pool Above ❑ In- 1Vo.oTLmergency Lighting grad. grad. ❑ Batter Units �" 1No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones .` I O.of Switches No.of Gas Burners 'Nee of Detection and Initiatin8 Devices t 1 r o,of Ranges No.of Air Conti. total Tons No.of Alerting Devices No.of Waste Disposers Neat Pump Number Tons KW No.of Self t ontained Totals:I""" ____� . .'Tons _�— Detection/Alertin�Devices No.of Dishwashers Space/Area Heating KW Local❑ Munictp Connection ❑ ' No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters Signs Ballasts Data Wiring: No.of Devices or Equivalent Telecommunicat(ons Whin No.Hydromassage Bathtubs No.of Motors Total HP Na of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: / 'Z 7i Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 cov9age is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify,under the ins and penalties of pry,that the information on this application is true and complete. A� ,/ FIRM NAME: !--,�� 6j i -T'✓c LIC.NO.: /_t'r Y Licensee: � 6 r;- ,y� Signature LIC.NO.: 4' c4-,SQ/g (If applicable.enter"exempt"in the license number line.) Bus.TeL No.:g7Sr �l`7 9 Address: D-6. .J cr7enb4 f�iZ S' [/l ✓e4ici D V Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requisbs Department of Pubic 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 0 owner's agent.Owner/AgentI Signature Telephone No. I PERMIT FEE $