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Home My WebLink AboutBLDE-21-006623 " t /I'(�,' Commonwealth of Official Use Only . Massachusetts Permit No. BLDE-21-006623 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:5/17/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 176 CRANBERRY LN Owner or Tenant Tom Simeone Telephone No. Owner's Address 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 basement. 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 nd. ❑ grnd ❑ No.of Emergency Lighting 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 I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Municipal Local ❑ Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts 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 S eci I certify,under the pains andpenalties o (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: DAVID R NICOLL Licensee: David R Nicoll Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 37557 Address: 144 DRIFTWOOD LN, S YARMOUTH MA 026641038 Bus.lt. Tel.No.::: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel. OWNER'S INSURANCE WAIVER:I am aware that the License does not have the liability insurance coverage normally required by law.But signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I I PERMIT FEE: $75.00 0-0- , e ( \ç}2 c P4e-, Z u ..' q�/� Official Use Only �nmmnnuiea[1!a- o� /t a dachcc�alf `(� Permit No. �'i) 3 ar1�- 3eparfm.eni o/.ire Serviced • . BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), CMR 12.00, (PLEASE PRINT IN INK OR TYPE L INFORMATION) Date: 1 V I ' t d-d?l City or Town of: Ak AVto t 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) —71c e_A&i `AL-g Py ___ZIfs'L Owner or Tenant rb"4 -4 UMOA E?vtf A1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Z' No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service c ''' Amps t d C' /?''Volts Overhead ❑ Undgrd ❑ 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: ` r--[!�[5'�Cf �`' S lfrx!yt/2 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- I No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones No. of Switches,N,N. No.of Gas Burners No.of Detection and Initiating Devices T No. of Ranges No.of Air Cond. TTot 1 N onso.of Alerting Devices No.of Waste Disposers Heat Pump Number - Tpns:_ KW No.of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection , - I . ,.. : No.of Dryers Heating Appliances KW Security Systems:* + No.of Water No. of No.of Devices or Equivalent Heaters KW No. of Data Wiring: Signs Ballasts No.of Devices or Equivalent No Hydromassage Bathtubs lNo.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.) Z 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 Iicensee 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 M BOND 0 OTHER ❑ cify:) I certify, under the mains and penalties of perjury,that the inform on on th ap cation • rue andj,, Plete. FIRM NAME: .. l pwti D N t c o LL,Licensee: •` uLIC.NO.: ��Signa re" LIC.NO.: (If applicable, enter"exempt"in the license tuber line.) - �c Address: � � t�(Z i}`T IltJ t';D j h ._ t Bus.Tel.No .: - � ,�a i dYMAU T rr1�- 03 b6 * f Mt. No.• �0� .� 6-"'7" (t�t.t�Per M.G.L. c. 147,s 57-61,security work requires Department of Public Safety "S"License: Lic.No. �fILCD OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 0)4 , required by law. By my signature below.I hereby waive this requirement. I am the(check one) ❑owner ❑ owner's agent. et Owner/Agent Signature ! l Telephone No. 1 PERMIT FEE: S I