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Home My WebLink AboutBLDE-22-003275 Commonwealth of Official Use Only At ,, '; Massachusetts Permit No. BLDE-22-003275 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:12/9/2021 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) 62 SILVER LEAF LN Owner or Tenant WARD HENRY JOHN Telephone No. Owner's Address WARD NORA,62 SILVERLEAF LANE,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 Npi • s New Service Amps Volts Overhead ❑ Undgrd ❑ O Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Basement remodel reZ7CD OCompletion of the following table mayaih I . , of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 3 V, , Transformers No.of Luminaire Outlets No.of Hot Tubs Generators 4.3 KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. 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 No.of Air Cond. Total n No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinu Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: William C Fligg Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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: $150.00 DECEIVE ® �(l1Ce `' i`oasnwnweaa el aaoachuesito Official Use Only DEC,. Permit Na. 22-3`Z7 - �»f of . .w BU I L DI N i + 'ENT Occupancy and Fee Checked Br'__ ; 1 ARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK An work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR 7�E ALL INFO TION) Date: k I City or Town of: .t,✓' 0 L ' To the Inspector of Wirees, By this application the undersigned gi es notice of his or her . on to perform the electrical work described below. Location(Street&Number) St W L \--0,,v2_ Owner or Tenant 6 t- ./t tr_ a,,_, 41 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building S vt c 1.2_,.`ce.►,,,- sIll 1 c.,/...(,, Utility Authorization No. Existing Service 7cx, Amps l7)frC{x Volts Overhead[a- Undgrd❑ No.of Meters New Service Amps I Volts Overhead L..,l Undgrd❑ No.of Meters Number of Feeders and Mnpacit3'Location and Nature of Proposed Electrical Work: et "...,x1c- �--t c..)C`\ r,A vi ksi Completion ofthe fo table may be waived by the Inspector of Wires. Total til No.of Recessed Luminaires No.of Cdl.-Susp (Paddle)Fans n o.fortpners KVA VA I Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool gra Above [� In- 0 No.of Emergency Lighting d. hind. 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 ILI No.of Ranges No.of Air Cond. No.of AlertingDevices TonsTotal of Waste DisposersHeat) Number Tops -K f NDeSelf-Contained- No. teetiontAlopevices No.of Dishwashers Space/Area Heating KW Local[I Man 0 , Connectiaa No.of Dryers Heating Appliances KW uric' yarcane:* No.of Ns ices or Equivalent No.of Water I{VV Heaters Signs No.of N .of Data Wiring: Balolasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors TotalHP -Telecommunications W a�. No.of Devices ar Eqa ivaient OTHER: Attach additional detail tfdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: [2- I -7-1 (When required by municipal policy.) Work to Start: 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' including"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 CI (Specify.) I cetmtfy,under littptflins atuipe of perjury,that the infaruradon on this application is true and complete.. f FIRM N I ��R'\ (-�tr'� t LIC.NO. 1 �3 Licensee: 4.1( rt. t Signature LIC.NO.: Of applicable,enter"exempt"in the license number line.) Bus.Tel.No.1 y 51 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 sin 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)0 owner ❑owner's agent. Owner/Agent _ �J Telephone No. PERMIT FEE:$ / v C/1 1 ;O