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Home My WebLink AboutBLDE-21-007229 Commonwealth of Official Use Only Permit No. BLDE-21-007229 ' . � Massachusetts 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:6/14/2021 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) 113 WILFIN RD Owner or Tenant HERTZBERG RICHARD E JR Telephone No. Owner's Address HERTZBERG IRENE,3 EAGLES NEST WAY UNIT 321, FRANKLIN, MA 02038 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: Wiring for family room addition. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 No.of Ceil:Susp.(Paddle)Fans 1 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 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 ❑ 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 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: 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: DAVID M HAWKINS Licensee: David M Hawkins Signature LIC.NO.: 31112 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN,YARMOUTH PORT MA 026752252 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: $75.00 V\ 1 4l'Lf/2 (q.,(KA_44) cI 9't /A ' /i ' gam) (1761f.im l 4 l Cow 4Iz-3 ( eearawarswai k al rrlassachees its Official Use v• trviesd v , }, e let 4 < Permit No. — Z2� j ,. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee blanChek) s. 1/(171 Slexve,btankl APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ot All work to be performed in accordance with the Massachusetts Electrical Code(MEC).5Z7 CMR 2.U0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (e 13/ 1 City or Town of: 1 igik yyN 40T j4 To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. a Location(Street&Number) 1/3 w// F/A-) Owner or Tenant r r C,I+M r D f f R.12.p;--A 6- 'Q< Telephone No. Owner's Address 3 i',-L r,.$ pd,-y '4./91 F wl4L,A. 1444- 3 qS' Is this permit in conjunction with a building permit? Yes f No 0 (Check Appropriate Box) Purpose of Building FA m,/y R v,-,, A-b IS i It o, Utility Authorization No. Existing Service l IX)Amps i d d a yo Volts Overhead ICJ. Undgrd[] No.of Meters / q New ii Service Amps / Volts Overhet!0 Undgrd[❑ No.of Meters Number of Feeders and Ampacity / /eve)'—f 3-� Location and Nature of Y / , Elecarkal Work: A }/ i //2 t e4wi, iyA t/ ix Completion of hefollvwingtable+ be waived by the I of Wires. t Na.of Recessed L No.of Ceil.-Susp.(Paddle)Fay No.ofTotal -` Transformers KVA : No.of Luminaire Outlets No.of Hot Tubs Generators KVA m No.of Luminaires S p.j Above In- NO.of Emergency Ligfittng `" No.ofwinning Enid, � gCnd. � Battery Units Outlets /D No.of Oil Burners FIRE ALARMS jNo.of Zones ` No of Switches No.of Gas Burners 'No.of Detection and t Inithrtlng Devices No.of Ranges No.of Air Cond. TTohi -No.of Alerting Devices Na'of Waste Dlsp era Pump Number Tops, KW No.of Self-Contained Totals:1........__..._. 1 __IKW______ Deteetion/A a , Devices No.of Dishwashers SpaceiArea Heating KW Local❑ Mun Connectlon 0 Other No-of Drytwo y :* No.of Water Noah$APPllaaexs KW a of I7 a or Equivalent Reuters Signs B.of ath Data Noo f eDevt or • , . No.Hydtnn usage BathtubsNo.of Motors Total HP Telecommunications Ner:ofDevicesorEq, : OTHER: , Estimated Value of lextrical Work: 1��v Attach additional detail if&siren or as required by the Inspector of Wires. (When required bye Policy) Work to Start: //7/q 1 Inspections to be requested in accordance with MEC Rule Ill and upon INSURANCE COVERAGE: Unless waived by the owner,nocompletion. permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance includingy "completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specitjr) I cersffy,ander the pains and pe es ofper}rrry,that the Information on this aPlikadan is true and FIRM NAME: eamPleta ® LIC.NO.: Licensee: ,4 U I i) ltAIw id. J/v._.,5 Signature), ,T. 4 , (If applicable,enter"exempt"in the license number line.) LIC.NO.: — /// Address: /L/ r,n.G/t 0iinnvyyS 1--.IL) `JAt�LMr itKA' c,2,62.3mt.Tel.No.. � `7' d,d 4:36a.5 *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 required by law. By my signature below,I hereby waive this coverage normally Own aer//AAgent requirement.eKneat. I am the(check one ■ owner III eV/Wesc e ult. Telephone No. PERMIT FEE