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Home My WebLink AboutBLDE-21-007342 43„/ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-21-007342 (05 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:6/17/2021 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) 84 WINDING BROOK RD Owner or Tenant PERKINS GEORGE M Telephone No. Owner's Address PERKINS JEANNETTE A,84 WINDING BROOK RD, SOUTH YARMOUTH, MA 02664 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: Replace motion detectors&install receptacles in basement. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil: No.of Total Susp.(Paddle)Fans 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 14 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons Tot No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Space/Area HeatinLocal 0 Municipal No.of Dishwashers P g KW Connection 0 Other: HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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: Mark B Kiefer LIC.NO.: 26093 Licensee: Mark B Kiefer Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 GRASSY POND DR, DENNIS MA 026382515 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 ❑ owner's agent. Owner/Agent Signature Telephone No. 'PERMIT FEE: $75.00 I 667?4(,4 s ►/ /\ eorn�xonwea[tli ai Vasoachuasffe Official Use Only /�j Aq f Permit No. -'2 —1 : ,al, 2.Parf,„�of Jim...S)etwicto I= >' Occupancy and Fee Checked _ `'-L, >: BOARD OF FIRE PREVENTION REGULATIONS jRev. 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 TY E ALL INFORMATION) Date: (, {r.-- ' City or Town of: A t t l(J Li Y h To the Inspector of Wires: By this application the undersi ed ves notice of his or her intention + perform the electrical work described below. Q Location(Street&Number) 'C1-- i/,,jz.)N n &', 4. �1 Owner or Tenant ( 'd A' ?C'_ a:-,t e A N!'. rt � 45 C'tQ. i N-S Telephone No.5v%' / f/GG/ Owner's Address 5-t /YL At Is this permit in conjunction with a building permit? Yes 0 No V (Check Appropriate Box) Purpose of Building e 'S(,jam N Ti )4 (.s Utility Authorization No. cci Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters u New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters qk ers Number of Feeders and Ampadty Location and Nature of Proposed ElecMcal Work: £P pt,Ace j"'r i o N -ei.e_c'" _ I N S '--- l I p Lu gs t n: ,Q A S O i e tv`i- Completion of the followingtable may be waived by the Inspector of Wires. LI No.of Recessed Luminaires No.of Cell.-Sussp.(Paddle)Fans No.o€ Total Transformers KVA ' ;; No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grad. (] vitt E] Battery Units ° No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS No.of Zones —No.of Detection and No.of Switches No.of Gas Burners Initiating Devices K, -° No.of Ranges No.of Air Cond. Total No.of AlertingDevices 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❑ Municipalion 0 Other CanaeM No.of Dryers Heating Appliances KW Security Syystems:* No.of Aevices or Equivalent No.of Water K 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: Cv [a-,,,,2.1 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 pennit issuing office. CHECK ONE: INSURANCE Di BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties o.f perjury,that the Information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee:n'11A k- '.e✓J,, Signature 77,4 _ LIC.NO.: E e (If applicable ent{ter 'e empt"in the license ber line.) Bus.Tel.No.: 1j6 7 2 Address: D -S ( -ASS .k-I -P ail U e- De-iLiM C� Alt.TeL No: 5 ,: *Per M.G.L.c. 147,s.57-61,secdrity work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 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)❑owner Q owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$