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Home My WebLink AboutBLDE-22-002255 #17 „„„. w Commonwealth of Official Use Only ft. \ ‘'\627 Massachusetts Permit No. BLDE-22-002255 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:10/19/2021 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) .021117 ANGELOS RD 0.68t 0 2Q7 Owner or Tenant THOMPSON WILLIAM P Telephone No. 1 Owner's Address BROWN-THOMPSON MICHELLE A, 17 ANGELOS RD, SOUTH YARMOUTH, MA 02664 6 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check :i :, Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 ' 0,'W, New Service Amps Volts Overhead 0 Undgrd 0 N i jf�s Ifirly Number of Feeders and Ampacity '�-/ ' Location and Nature of Proposed Electrical Work: Additional living space)`; "'' 1' '”- ' ,in "Fro" • Completion of the following table may be ai eR tor of Wires. No.of Recessed Luminaires No.of Ceil.-Sus . Paddle Fans No.of p( I t Transformers o No.of Luminaire Outlets No.of Hot Tubs Generators 4 KVA No.of Luminaires Swimming Pool g bO�'e ❑ grnd ElNo.of Emergency Lighting rnd. 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 Devices No.of Ranges 1 No.of Air Cond. 3 Total No.of Alerting Devices Tons Heat Pump Number , Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 Heating Appliances KW Security Systems:* No.of No.of Devices or Equivalent Noaters ater 1 KW No.of No.of Ballasts Data Wiring: 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 {2"°4-itr L//7 1 Commonwealth o`Maosachuretio Official Use Only Tit !r c� Permit No. 3spartmend o/gam services • BOARD OF FIRE PREVENTION REGULATIONS Reel/0 Occupancy and Fee Checked ''-s'' (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code a� ),52 MR 12.00 (PLEASE PRINT IN INK OR TY E INFORMA ON) Date: ` 1, o City or Town of: I( \ To the Inspector of res: '44— By this application the undersign '1..ce of or her intention to perform the�electri �yo�On��G�l V low. i4 a�vL Location(Street& umber) ' k,c2s a y Owner or Tenant)0 �'1 k "'- � j \ Y)Telephone NC fl`f�Z(D( 0 2 Owner's Address " e ' ((n,1 Lk k m pp�. QI -(G eo �j• ' 1 V Is this permit in conjunction with all!" ding permit? Yes Le No ❑ (Check Appro riate Box) Purpose of Building i,),(� .,? .(¢U Authorization No. /ljf A- Existing Service #Q0 Amps / Volts Overhead Overhead Undgrd 0 No.of Meters New Service. Amps / Volts Overhead❑ Undgrd❑ No.of Meters I Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work:1�E ��nr.p�� pa, % )-et,r n4. �j-�(s 4.1 oi Completion of the following table may be waived by the InsTecfor of Wires. Lki No.of Recessed Luminaires No.of Ce 1.-Snap.(Paddle)Fans No.of Total `2. Transformers KVA CI No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin pool Above In- No.of Emergency Lighting g �rnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners "No.of Detection and Initiating Devices Tota No.of Ranges 1 No.of Air Cond.3 Tonal No.of Alerting Devices No.of Waste Disposers Heatip Number.. Tons _KW No.of Self-Contained . . ... Detection/Ale i�Devices No.of Dishwashers \ Space/Area Heating KW Local 0 C Man Systems:* 0 OtherNo.of Dryers 1 Heating Appliances KWSecurity urn oat f Devices:or Equivalent No.of Water KW No.of fgns No.of Data Wiring: HeatersBallasts No.of eviices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: C10, Vhen required by municipal policy.) Work to Starl ps4„; Z�Z 1 Inspecti to be requested in accordance with MEC Rule 10,and upon completion. INSURANC OVE GE: 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 ex, ibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER a (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: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 itjAuDnce coverage normally requi�nred bye law. �By m signature below,I hereby waive this requirement.ban�e'`heck one) wner ❑owner's agent. Si nature - 1 �, . S� 1C "17 g � Telephone No. PERMIT FEE:$�-5,co