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Home My WebLink AboutBLDE-23-004066 �A1i1 Commonwealth of Official Use Only �. Massachusetts Permit No. BLDE-23-004066 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:1/24/2023 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intents to perform the electrical work described belo. r�, f Location(Street&Number) 20 BRAY FARM RD o 6-30 " 0 3 l Owner or Tenant LESLIE WHITNEY Telephone No. Owner's Address 20 BRAY FARM RD N,YARMOUTH PORT, MA 02675-1550 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 renovations Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 9 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 5 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and Initiative Devices .No.of Ranges 1 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/Alertinu 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 Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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:) ig i —4/ '3-- Cp 1 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Alfred B Watters Licensee: Alfred B Watters Signature LIC.NO.: 24033 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 LINCOLN VILLAGE RD, HARWICH PORT MA 026461601 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 -a0r.c,C1 9-41-3 R.:m.1-G- (ell-7/z31 „ , - ` RECEIVED __ L. . ...: ,- - -- ;- y,,,,,� Consnronwsa o`rs'/addachudelld Offi cial fficial Use Only artmsnf o`c7rs S . Permit No. ( ,-i. P ..fid � !° BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked !Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK KAll work to be performed in accordance with the Massachusetts Electrical Code( C),527 MR 12.00 2 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: vn Date: � �3 e,23 �' By this application the undersigned giv s notice ofto To the Inspector Wires: �tU 2Perf We electrical ork described below. Location(Street&N tuber) z Owner or Tenantpa- Owner's Address Telephone No ( Is this permit in conJ ction,with a buiidi permit? es Purpose of Building No ❑ (Check Appropriate Box) WO Utility Authorization No. Existing Service Amps f O / �.k)y01ts Overhead VI New rvice ❑ Undgrd� No.of Meters 3 ---'�”" Amps rd_.__./ Volts Overhead 0 Und Number of Feeders and Ampadty g El No.of Meters Location and Nature of Proposed Electrical Work: oc vi Com,letion o the ollowin•table m, be waived b the In ,ector o Wr'res. rs No.of Recessed Luminaires ,o.o No.of Cell.-Soap.(Paddle)Fans ota No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA A No.of Luminaires ' ' o.o mergency g ,ng _�Swimming Pool rndve. ❑ n-d. ❑ Batte Units No.of Re ceptacle Outlets 5 No.of 011 Burners FIRE ALARMS No.of Zones c. - No.of Switches i No.of Gas Burners 'o.o r etec on an I;r No.of Ranges Initiatin. Devices i No.o Air Cond. ota Tons No.of Alerting Devices 'eat 'ump um pus rs Totals: _- .......__...._. o e out: ne, No.of Waste Disposers No.of Dishwashers Detection/Alert ection/Alert Devices Space/Area Heating KW Local 0 'un e p No.of Dryers Heating Appliances KW ecu ty Cstems: 0 � o.o ' a er No.of Devices or E,uivalent Heaters ' 'o.° `o.o S ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Motors a ecommNo.of un ca•ors "evices or E•uivalent Total HP g OTHER: No.of Devices or E,uivalent 3 Estimated Value f Ele ical Work: t?�0O Attach additional detail if desired,or as required by the Inspector of Wires. Work to start: � �.aj a1 (When(Whenrequired by municipal policy.) SURANCE COVE Inspections to be requested in accordance with MEC Rule 10,and upon completion. the licensee provides proof f liability si insurance i waived by ncluding lud g he "cm no pleted operation"ermit for e performance or its substantial work may issuentunless undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE equivalent. The I cert/fy,under the -,i and,ens/tBO� 0 OTHER 0 (Specify:) FIRM NAME: A ,s i i ' rl'b that the Information on this application is true and complete. Licensee:f _ t .---0 LIC.NO.: G' 033 Addplic applicable, ' of I Ixem,I„in Mali -0 e numbe i e./ Signature =,/ i... �/ n LIC.NO.: p *Per M.G.L.c. 147,s.57-61,security t P,t'�-- Bus.Tel.No.. -- i(0 i ty 1 requires Department of Public SafetyAlt.TeL No.: 1 OWNERS INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally" required by law. Bymysignaturese: Lic.No. Owner/Agent below,I hereby waive this requirement. I am the(check one ■ owner • owner's a ent. Signature Telephone No. PERMIT FEE:$