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Home My WebLink AboutBLDE-22-003393 ip Commonwealth of Official Use Only ill ht, • Massachusetts Permit No. BLDE-22-003393 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:12/14/2021 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 electric work escribed below. Location(Street&Number) 63 ABELLS RD Owner or Tenant Dan Skkt Telephone Owner's Address 63 ABELLS RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap ropriate Box) (j Purpose of Building Utility Authorizatio No. 3L4'5n�� Existing Service Amps Volts Overhead 0 Undgrd No.of Meter New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity - Location and Nature of Proposed Electrical Work: Remodel residence Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 15 No.of Ceil:Susp.(Paddle)Fans 2 No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 40 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 25 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: 3 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 K. Davidson Signature LIC.NO.: 100449 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 Newcomb Place,Taunton MA 02780 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: $180.00 _._, —iii,L47 0 t A -7-0-1,79E- A1494,3zge) 11-- - 61Aft-rr 11)627k -co 1/4I2z v t (Via- (S Nor Ao60Y� Cruita.-4P-Isvtoge-ticAt L jI1� V z l i vc cis C _) 64 D R E C E I V nnE QQ/` �/j� // Official Use O ly <,_ L.om. .n ealth o/ a66acI elt6 4r _* 93 _ ryi 2021 Permit No. `'✓ri J -�n _ DEC4 ar mend or dire eruice3 :_fit_- �.. .} - t Occupancy and Fee Checked ,_ pq 7� NA- t _= �gUlll�0j� PV EIKC P EVENTION REGULATIONS [Rev. 1/07] (leave blank) By — -_�y� y- APPLICATION FOR PERMIT f O PERFORMELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT EV INK OR TYPE ALL INFORMATION) Date: O('_( / 13 / .Z ,)- City or Town of: yarrt,ou411 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) 6 3 in,//.5 rpl Owner or Tenant ,i H / sk,&T //e Telephone No. 78/-g 31 -,L7111 Owner's Address Is this permit in conjunction with a building permit? Yes It No ❑ (Check Appropriate Box) Purpose of Building ii8Sj d in j fi Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd n No.of Meters New Service )...tf) Amps !,. b/24e Volts Overhead 0 Undgrd U No.of Meters 1 Number of Feeders and Ampacity J Location and Nature of Proposed Electrical Work: jVej, r p a, i Q� /"1 Ode_Q- Completion of the followin&table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires i S No.of Ceil:Susp.(Paddle)Fans 2- Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets Lio No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches 1. s No.of Gas Burners Initiating Devices No.of Alerting No.of Ranges I No.of Air Cond. Total i Tons Devices Heat Pump KW No.of Self-Contained No.of Waste Disposers Totals:I Number Tons { Detection/Alerting Devices Municipal No.of Dishwashers I Space/Area Heating KW Local❑ Connection ❑ Other HeatingAppliances KW Security Systems:* No.of Dryers I No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: ..1 Heaters Signs KW Ballasts 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. Estimated Value of Electrical Work: /ti 000 (When required by municipal policy.) Work to Start: 0c .-i I LI 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 ❑ 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: l L LIC.NO.: /Q p yy 9 Licensee: /�► G7 r`1 Yt-� G(/1 sel Signature LIC.NO.: (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: TM ",2- - -7..7 Address: /.) /(/rfr L,,i-s, 6 fl/ 7 vo /0'7 /'i# 0.27i a 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)❑owner ❑owner's agent. Owner/Agent Telephone No. I PERMIT FEE: Signature