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Home My WebLink AboutBLDE-23-004634 Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE-23-004634 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:2/22/2023 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) 41 TALL PINES DR Owner or Tenant RICE JOHN B Telephone No. Owner's Address GEIKIE-RICE LYN,2116 AMARGO WAY, NAPLES, FL 34119 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: Kitchen, powder room, &2nd floor. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 8 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 ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Ton No.of Waste Disposers Heat Pump Number , Tons 1 KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Watery No.of No.of Ballasts Data Wiring: Heaters 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 ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Joshua Stone Signature LIC.NO.: 56574 (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. II PERMIT FEE: $75.00 C . nw 4 44'4 is 1444a Official Use Only `V 1 eparf► ad a ... -' Permit No. v BOARD Occupancy and Fee Checked OF FIRE PREVENTION REGULATIONS [Rev. li'07 j (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordion*with the Massachusetts Electrical Code(MEC).527 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE ALL INFORM4TJON) Date: City or Town of: � �1:t, j,,r To the Inspector of Wires: By this application the undersign gives notice of fiis or her intention to j J I ,]` � perform the electrical w described+ beIawl Location(Street&Number) "ta-L( P: vo L 5 pr.. v .t/l/f . -k /: )f 7_ Owner or Tenant ..�f , yv . 11 t Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yea No tl--�� u (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service jc C Amps C)C) /074, Volts Overhead[3 Undgrd Er No.of Meters 0 New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity 6` Location and Nature of osed Electrical Work: +,h %,� , ( / ` f i2". �Gt u v, Completion of thefollowin&table may be waived by the Ivrector of Wires. No.of Recessed Luminaires No.of Total ti)te No.of Cei}.-Susp,(Fuddle)Fans Transformers KVA Qt No.of Lumnnarre OutletsNo.(Allot Tubs Generators KVA No.of Luminaires Swimming Poo. Above ❑ In- Pro.of emergency Lighting , grad, all& Q Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Na.of Switches i 'Na.of Detection and L No.of Gas Burgers hiiiiithie Devices I Li No.of Ranges t No.of Air Cond. Total No.of Tom Alerting Devices No.of Waste Disposers 'Heat Pump Number Tons KW "No.of Self-Contained Totals:I " — Detection/Ale , „ Devices No.of Dishwashers I Space/Area Heating KW 'Local 0 Mon. 1, Conan 0 Other No.of Dryers Heating Applistnces KWSecu S : No.of Water No.of Nority.of or Eguivslen Heaters ' SignsNBa°�° Data Wirinf: sts No. dro No.of Devices or Equivalent ' massage Bathtubs No.of Motors Total HP Tel mmunications WW aty� OTHER: Na of Devices or Egavalstit Estimated Value of Electrical Work: Attach additional detail rf re4 or as requiredby the Inspector of Wires. Work to Start: —),c...) - � enrequired bymunicipalpo�Y) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the the licensee provides proof of liability insurance including"completedperformance of is substantial electrical work may issue unless undersigned certifies that such cov is in force,and has exhibited operation"sameto coverage or its sssuing Hal equivalent The CHECK ONE: INSURANCEproof of to the permit issuing office. BOND 0 OTHER FIRM ,under the AME. pains and penalties ofpe!�',that the �n on this• a�lfcatforr is true and co Licensee: ` : . NO.: Lifcensce: c in the license number line) Signature LIC.NO.: Addrms: / Bus.TeL No.: Per M.G.L.c. 147,s.57-61,security work requirescety Alt;Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Departmentcensee not µSve the liabilli Lin. c required by law. By my signature.below,I hereby waive this �'insurance coverage normally Owner/AgentNi ►cnt. I am the(check one II owner owner's :ant. Signature Telephone No. PERMIT FEE:$ /)q/ ' 7Y