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Home My WebLink AboutBLDE-23-000265 ar Commonwealth of Official Use Only £ i Massachusetts Permit No. BLDE-23-000265 4,.... 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:7/18/2022 City or Town of: YARMOUTH To the Inspector of Wires:Om By this application the undersigned gives notice of his or her intention to perform the electrical work described belo i/9 22.33 Location(Street&Number) 7 CIRCUIT RD WEST Owner or Tenant NUGENT MARK C Telephone No. Owner's Address 468 PLAIN ST SUITE 3, MARSHFIELD, MA 02050-2252 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 Ampaci ^T ty Location and Nature of Proposed Electrical Work: Replacement bathroom fan. 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 Initiatine 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 Totals: Detection/Alertine 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 Equivalent 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 Eauivalent 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 ❑ (Specify:) 17 L( l 'J tT" 3 $ .7..- I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Keith A Howes ��I tip,le �k �u Licensee: Keith A Howes Signature LIC.NO.: 11325 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:221 MEADOW ST, CARVER MA 023301524 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: $50.00 VA 7/,`1/?'Z' (1:(-o-03t9k- t M ofn 136ns Nor &7r 2S J C-amsnonuiea&nf//�y�jj�/ I Ma-mace Official Use Only Permit No. ZZ- 02- 5 = r1!_ M 2epartment ol3ire ServaceJ i t— 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),527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL RMATION)i Date: 7h« a.& B City or Town of p j- ,04 To the Inspector of Wires: y this application the undersi gives notic f his or her inte n top rform the el ctrical work described bel Location(Street&Number) 7 reb ow. L �a �r Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd g C No.of Meters New Service Amps / Volts Overhead n Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (24 i s Oaf 1a'an /', 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 Tons No.of Alerting Devices 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 Local❑ Municipal Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent '' No.of Heaters 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: /'/f1 ).J- 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 ❑ (Specify:) I certify,under the pains and penalties f perjury that the information on this application is true and complete FIRM NAME: ��fs / PP tr.' Cfi-e LIC.NO.: /e.?W5- 749 Licensee: Signature 4/Y4 LIC.NO.: (If applicable,enter "ex mpt"in the license number line.) ' Address: Bus.Tel.No.: T*Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"S"License: �t.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 El owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $