HomeMy WebLinkAboutBLDE-22-005660 Commonwealth of Official Use Only
fE Massachusetts Permit No. BLDE-22-005660
Thi BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
`Rev.1/071
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:4/5/2022
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) 52 ALDEN RD
Owner or Tenant HEBERT DAVID W Telephone No.
Owner's Address HEBERT DEBORAH ANN,68 MERRIAM LN,SUTTON, MA 01590
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: Replace ungrounded wires on first floor. Kitchen remodel&lighting.
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 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 Number Tons KW No.of Self-Contained
p Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Ballasts Data Wiring:
Heaters Signs No.of Devices or Equivalent
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.
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: DAVID W SPRINGER
Licensee: David W Springer Signature LIC.NO.: 21170
(If applicable,enter"exempt"in the license number line.)
Bus.Tel.No.:
Address:70 Bishops Ter, Hyannis MA 026012106 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: $75.00I
city 774,„ i, ._,
g4 C,.ommonw.a[th _/ladeacls its Official Use Only
7 Permit No �Zl 5(h,t7
.Ili .5spa st oil.. sru
Occupancy and Fee Checked
;, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank)
4--
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
--kr (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 /112 Z
v City or Town of: West `C&CMU LAAN To the Inspector of Wires:
C By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
0 Location(Street&Number) S a \ i,
Owner or Tenant 3j 1-ekyn th`be(' Telephone No.
N t Owner's Address
N1 Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box)
r Purpose of Building Q i \,4 Utility Authorization No.
N Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters
,�.:.lba Number of Feeders and Ampacity
`n i Location and Nature of Proposed Electrical Work: ` fr loc.) C W
L?re..5 Kf kl,& re,—de 1 ati() 6 t i 1,
CompletWn of the fallowingtable mtv be waived by the 1nssector of Wires.
kil
No.of Total
QNo.of Recessed Luminaires No.of CelL-Snap.(Paddle)Fans Transformers KVA
', No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- .No.of Emergency Lighting
1:: No.of Luminaires Swimming Pool grad. ❑ grad. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches O.of Gas Burners -No.of Detection and
Initiating Devices
i',: No.of Ranges No.of Mr Cond. Tonsl No.of Alerting Devices
Heat Pump Number Tons _._KW_.,..,_.'No.of Self-Contained
Na.of Waste Disposers Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local 0 Con colon 0 Other
No.of Dryers Heating Appliances KW Security Systems:*
ry No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:•
Heaters Signs Ballasts No.of Devices or Equivalent
No.H dro a Bathtubs No.of Motors Total HP TelecommunicationsofDevices
r W
y »g No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: I Ct OW.,,, (When required by municipal policy.)
Work to Start: 312.ct/22 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 cov a 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 pains and penalties of pedtuy,that the information on this application is true and complete. a
FIRM NAME: �j C L 4J f';4 E.C c(- / LIC.NO.: Z.117d i 4
Licensee: D0.v� � Sp f WI �✓ Signature . LIC.NO.: i 3 Z�31 IS
(If applicable,enter"exempt"in the'licens tuber line.) Bus.Tel.No.: Sig 344 6 139
Address: b 8,3 L o 5 ((; l '41tf'S Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires HMpartment 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 PERMIT FEE:$
Signature Telephone No.