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Home My WebLink AboutBLDE-22-003870 or Commonwealth of Official Use Only E. ,V Massachusetts Permit No. BLDE-22-003870 R BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 1 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:1/11/2022 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perm the electrical work descri ed below. Location(Street&Number) 16 HARVARD ST T t tom. !V Owner or Tenant OJ3AUR♦< Ei 'M Telephone No. Owner's Address , 16 HARVARD ST,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 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Basement 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- ElNo.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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Siens 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: Licensee: Matthew Kane Signature LIC.NO.: 55328 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:35 Harvard Street,South Yarmouth Ma 02664 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 atoms r/1a f cnVeiL 1/(� I !:2 .% Commonwealth of s'//amachusalte Official Use Only �Permit No. 7� � �. - •—�tR. 2sparimsnf of ire Serviced '''1'I'' J Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1' l i l /''�Z. Z 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) / E t V Owner or Tenant r.;()el lel R e n a Owner's Address lc..fle4 4e We Arle Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /0 0 Amps /; c; / J'Wolts Overhead EK Undgrd❑ No.of Meters i New Service Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity i Location and Nature of Proposed Electrical Work: Be eMt�n.f ` 8 "� /�U (5),„, `tu Completion of the followingtable may be waived by the Inspector of Wires. f!! No.of Recessed Luminaires No.of Cell:Sus . No.of Total .! p (Paddle)Fans Transformers t No.of Luminaire Outlets KVA rr‘ No.of Hot Tubs Generators KVA t' No.of Luminaires Swimming Pooi Above ❑ In- No.of Emergency Lighting - grnd. Rand. ❑ Battery Units `` No.of Receptacle Outlets No.of Oil Burners . " FIRE ALARMS lNo.of Zones No.of Switches No.of Gas Burners No.of Detection and ' No.of Ranges Initiating Devices No.of Air Cond. otal Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I N imber 1 Tons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ' No.of Dryers Heating Appliances KW Security Systems:*Connection ❑ °th� No.of Water , No.of No.of Devices or Equivalent Heaters No•of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work toted Va (When 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"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 ❑ OTHER 0 I certify,under the pains and penalties of perjury,that the inmfornation on this application is true and complete. FIRM NAME: e,f t Otc't:✓ i•.i+/l e Licensee: i'7 c✓ K�n e LIC.NO.: '1 G¢/�jc� (If applicable,enter"exempt"in the license number line.) SignatureT�--— LIC.NO.:SS Address: •Bus.Tel.No *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe S"License: Alt Tel.No,: Lic.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 Owner/Agent owner III owner's a:ent. Signature Telephone No. PERMIT FEE:$