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Home My WebLink AboutBLDE-22-03893 3\f/i0 Commonwealth of Official Use Only tr . ,I Massachusetts Permit No. BLDE-22-003893 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:1/12/2022 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) 30 REFLECTION WAY Owner or Tenant BARTHE SHAWN L Telephone No. Owner's Address BARTHE JOAN E,2 DORNOCH RD, RAYNHAM, MA 02767 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: half finished basement. 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 0 In- ElNo.of Emergency Lighting grnd. grad. 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 Initiative 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 ❑ 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ROBERT W PIERCE Licensee: Robert W Pierce Signature LIC.NO.: 12359 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 FOSTER RD, E SANDWICH MA 025371040 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:$75.00 al‘ktpi- il i 01-7.i2/k- - cL /.14' RECEIVE ® v JAN 1 2 202� w,�„ omeso ea& adac Official Use Only �" . Y gt ` �+{LDING UEI'AkTr ZNT ( _Z2��[�•�.4 M' k _ - _ e'= of Of ssrvicse Permit No. L- --I�`� .le BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked / [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: [ 2-2-- City or Town of: YARMOUTH To the Inspector f Wires: 1By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 30 �L-4-t C n Owner or Tenant f Telephone No. y Owner's Address >`!t- �- ,- 2,Z J Is this permit in conjunction with a building permit? Yes Purpose of Building �� c,` ty A❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps Volts Overhead al New Service ❑ Undgrd[` r No.of Meters J c. 3 Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampadty g ❑ No.of Meters Location and Nature of Proposed Electrical Work: vi tik rft• Comdetion o the ollowin_ table m, be waived b the In ,ector o Wires. No.of Recessed Luminaires eVNo.of Ce Tranll.-Sasp.(Paddle)Fans 'Transformers ota 14 CA No.of Luminahe Outlets sformers KVANo.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool ' 'Ve rod. ❑ n- o.o Units cy g ng nd, ❑ Batte Units No.of Receptacle Outlets No.of 011 Burners '� FIRE ALARMS No.of Zones '-� No.of Switches No.of Gas Burners o.0 t etec on an • II' No.of Ranges Initiatin, Devices No.of Air Cond. ota Tons No.of Alerting Devices No.of Waste Disposers 'eat nmp `um er ons ' �� Totals: .....______._................__..._. o.o e out: ne Detection/Alertin No.of Dishwashers Devices Space/Area Heating KW Local❑ •un c pa No.of Dryers Heating Appliances KW ecu ty Cystems: El "her `o.o `' iring: Hacee S L ns Ballasts KW .o.o o.o No.of Devices or E i uivalent Data ofDe No.Hydromassage Bathtubs No.of Devices or .uivalent No.of Motors Total HP a ecommun ea•ons " r i g• OTHER: No.of Devices or E•uivalent Estimated Value of Electrical Work: Gi12! Attach additional detail iifdesired,or as required by the Inspector oJ'Wires. Work to Start: (When required by municipal policy.) INSURANCE COVERAGE: Unlesspwaived by the owner,no permit e tions to be requested in accordance h thewith BCRlof electrical work upon completion. the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equi alent.Thess 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 I certify,under the pains and 0 (Specify:) Pe es of perjury,that the Information on this application is true and complete. FIRM NAME: d h-(r at. ,� C.� Licensee: �;'y LIC.NO.: i�- 5-� (If applicable,enter"esenrpt"in the license number line.) Signature LIC.NO Address: 5�""`� *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Bus.TeL No• Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally No. required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent owner (♦ owner's a:ent. Signature Telephone No. PERMIT FEE: at)