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Home My WebLink AboutBLDE-22-000733 ., Commonwealth of Official Use Only t. 1 Massachusetts Permit No. BLDE-22-000733 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:8/9/2021 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) 95 PLEASANT ST Owner or Tenant George Rodrigues 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: Swimming pool. 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 t" Total Transformer li KVA No.of Luminaire Outlets No.of Hot Tubs Generators/J KVA No.of Luminaires Swimming Pool Above Li 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 D No.of Ranges No.of Air Cond. 1 Dotal No.of Ale evices No.of Waste Disposers Heat Pump Number I o KW No of elf-a nta Totals: Det c,o:,0, . ng Devices No.of Dishwashers Space/Area Heating KW Loc unicipal 0 Other: Connection No.of Dryers Hea ng Ap 'antes Kt ^ u ty Systems:* o. Devices or Equivalent No.of Water KW No.o No.of is ata Wiring: Heaters Signs .of D vices or quivalent No.Hydromassage Bathtubs No.of M s Tot P T eco u ti i:s Wiring: N ovi.•s i r "i uivalent OTHER: Attach addi ail i ired,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: LEON KNIGHT Licensee: Leon Knight Signature LIC.NO.: 20979 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 PILGRIMS WAY, BREWSTER MA 026312061 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE: $85.00 - 1 t' € goktt�, iA a litit-ly�s 80 e/cto(2, te- R E c--E__I_v. E AUS "74 Commonwealth / aaaachuo.tta Official �� °j Use Only ° ,_' 622 (0733 cc�� c7 Permit No. B U i l D I N `E r►+,,`hr 2Jspartmsnt o f,}ice&ry cse 8Y t1 t t., BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checkedy [Rev. l/07] (leave blank) N. APPLICATION FOR PERMIT TO PERFORM ELECTRI AL WORK All work to be performed in accordance with the Massachusetts Electrical Code MEC 5 7 C 12.0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9— 3 City or Town of: YARMOUTH To the Inspe or of Tres: By this application the undersigned gives notice o 's qt her intention top, orm the 1 et 'cal work described below. Location(Street&Number) 9 s'' t/ ��r��1 f Owner or Tenant Qj j ,,pp j !d ,( C, f `. r�K�(a Telephone No. ` I wner's Address UU �f Is this permit in conjunction with a building permit? Yes A. No Purpose of Building 0 (Check Appropriate Box) C Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity ' 1, Location and attu�re of Proposed Electrical ork: r "� pt C mplet onefollowin table maybe waived C. No.of Recessed Luminaires by the Inspector of Wires, No.of Cell.-Soap.(Paddle)Fans No.of Total ;t No.of Luminaire Outlets Transformers KVA 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 INo.of Zones No.of Switches No.of Gas Burners -No.of Detection and Initiating Devi It.r No.of Ranges Devices No.of Air Cond. Total v. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I limber Tons KW No.of Self-Contained Totals:I }_ Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municip - No.of Dryers Connection ❑ Other iY Heating Appliances KW ecu ty ystems: o.o Heaters KW ° ° o.o No.of Devices or E uivalent Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Motors No.of Devices or E uivalent Total HP ecommun ca ons r g OTHER: No.of Devices or E a 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 A BOND 0 OTHER 0 (Specify:) I certify,under the,•sins and pe al's of'erJ ry,I. t the information on this application is true and complete FIRM NAME: L , ` 4 Licensee: " ..-_ ,Or / e- LIC.NO.: Signature (If applicable,enterxe.pt"in the llc. numb•r line.) �./ LIC.NO.: Address: �r Id //i Bus.Tel.No.• *Per M.G. c. 4 ,s ;7-61,security work re.•r ;s D� �i7,4� partment of Public Sae Alt.Tel.No.: OWNER'S INSURA CE WAIVER: I am aware that the Licensee does not have the liability insurance coverage o ty"S'License: Lic.No. required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent g normally Signature � owner / owner's a:ent. Telephone No. PERMIT FEE:$