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Home My WebLink AboutBLDE-21-007601 �� Commonwealth of Official Use Only q Massachusetts Permit No. BLDE-21-007601.ArTill 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:6/30/2021 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) 80 CRANBERRY LN Jam'/7ii - 9 Owner or Tenant DUFFY ARTHUR J Telephone No. Owner's Address DUFFY TRACY A, 114 HUDSON ST, NORTHBOROUGH, MA 01532 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appro• iate Box) g Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No. New Service Amps Volts Overhead CIUndgrd 0 Lig,466 eTJntANumber of Feeders and Ampacity rs Location and Nature of Proposed Electrical Work: Finish of addition. ( yor 4 Completion of the following table may be waived by n 14. ., P Ores. No.of Recessed Luminaires 41 No.of Ceil:Susp.(Paddle)Fans No.of To • 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 16 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers 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 Data Wiring: Heaters Siens 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 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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 c?,u-r 6,,d.e.- , ,....0) e/242,11g, &pi_tat. 4 wituu6 tiegola9 ilif . Wilt CC(ILL It . Commonwsafth oi l vlaeaaciiuesttd Official Use Only tit« t cc� cc�� n�7 'C� t ' 11:„ F: 2l partmsnt el irs&,.vres0 Permit No, (� a ilf'q, 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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 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) 0 �� Owner or Tenant 0 u) iv E- 12— Owner's Address 0 _ �y L�� Telephone No. 2, '� by07 1 Is this permit in conjunction with a building permit? Yes No El (Check Appropriate Box) Er Purpose of Building _ 1 -5) �!/ I L._ Utili Authorization No. Existing Service a.aa Amps / Volts Overhead Undgrd❑ No.of Meters New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters I Location and Nature of Proposed Electrical Work: /Ni Sf AD 7 1I0N nd Hsu Com letion o the ollowin table m be waived b the Ins ector o Wires. No.of Recessed Luminaires No.of Cell:Sas ...'{ p.(Paddle)Fans — °•° ota "=�t No.of Luminaire Outlets Transformers K�rA r:.�� No.of Hot Tubs _ Generators KVA No,of Luminaires Swimming Pool rnd.e ❑ n °•° mnitsergency g n nd. ❑ Batte U g ' No.of Receptacle Outlets ( "` No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners _ o.o etec on an �' No.of Ranges Initiatin Devices No.of Air Cond. ota Tons No.of Alerting Devices eat ump um er ons o.o e - onta ne No.of Waste Disposers Totals: Detection/Alertin Devices No.of Dishwashers — Space/Area Heating KW Local❑ un c►p No.of Dryers — Heating Appliances KW ecu ty Cyst ms on ❑ �� o.o a er ° o No.of Devices or E uivalent Heaters — KW ° Data Wiring: Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP a ecommun ca ons r g OTHER: No.of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (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 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: LIC.NO.: Signature LIC.NO.: (If applicable,enter"exenrp["in the license number line.) Address: Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. Alt.Tel.No.: OWNER'S INSU NCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. my .gna e be ,I hereby waive this requirement. I am the(check one Owner/Agent owner • owner's a_ent. ✓Signature W Telephone No ✓73.3 ['I)d PERMIT FEE:$ S.7-77— c