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Home My WebLink AboutBLDE-22-001255 Commonwealth of Official Use Only A, Massachusetts Permit No. BLDE-22-001255 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:9/3/2021 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 electrical work described below. Location(Street&Number) 112 DRIFTWOOD LN Owner or Tenant Cindy Baratta Telephone No. Owner's Address 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: Renovate 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- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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 Totals: Detection/Alerting 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 Signs 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: William F Dougherty Licensee: William F Dougherty Signature LIC.NO.: 13932 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 LOWELL DR, ORLEANS MA 026534841 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 Dile:, - 1,6 0e Kf. REC_E.L._YE ° r -_. A,. EPt Z 2�21 .nwaaçoof% a edac4usette Official Use Only ,• er 'i�� , t PAR[MEN • nc� �7 Permit No, t Z2� (-2 .i 1 w s�N� J _—� 1parttmsni o�.}irs&mica ,,'_ , BOARD OF FIRE PREVENTION REGULATIONS [Rev. p and Fee Checked ' '' 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(, E ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 Z Zb1- City or Town of: YARMOUTH To the I ,e for of Wires: By this application the undersigned gives notic of his or her intention to perform the electrical work described below. Location(Street&Number) IIZ, On tilAr,eA L(AM,t. 5",V 04`1'VI,6o f Owner or Tenant C &d y Q ts,rOcif ek Telephone No. Owner's Address S' .t Is this permit in conjunction with a building permit? Yes 0 No N (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: Re44 c . ni p iv.. MA& fwi.',/„ 8' -f iA)D kntot,lJ1 fL o to Ct J s""7l v�o Completion of thefollowingtable may be waived by the Inspector of Wires. No.of Total ti No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA 'Z No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting -t No.of Luminaires Swimming Pool tirnd. ❑ grnd. ❑ Battery Units _ No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.of Detection and c Initiating Devices t 1 i No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW �No.of Self-Contained Totals: Detection/Alerting j)evices 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 Equivalent No.of Water , 'No.of 'No.of Data Wiring: Heaters Sys Ballasts No.of Devices or Equivalent No.Hydromasaage 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 1 trical Work: (When required by municipal policy.) Work to Start: ? Zdz( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE O RAGE: 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 tag, 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: LIC.NO.: Licensee: lopj t'Duet r.. Signature LIC.NO.: 1797 Z _ applicable. i the!1 um r i e .i `A.�e24�� Bus.TeL No.: Z O7�fr Address: !O L/ee.(ice�1 0l►'Y !�v` 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$