HomeMy WebLinkAboutBLDE-22-006436 Commonwealth of Official Use Only
` A�. , Massachusetts Permit No. BLDE-22 006436
157;;§
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:5/9/2022
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) 14 CARTER RD
Owner or Tenant BECKER PAUL V TRS Telephone No.
Owner's Address BECKER MARY C, 341 LAKESHORE DR, MARSTONS MILLS, MA 02648
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization N'd.
Existing Service Amps Volts Overhead 0 Undgtt cN o.of Meters
New Service Amps Volts Overhead 0 Undg4+ 40,of Meters
Number of Feeders and Ampacity V Q '' r
Location and Nature of Proposed Electrical Work: Replacement furnace&water heater. .
Completion of the following tableirlay be waived by the Inspector of Wires.
No.of Recessed Luminaires No.ofCeil.-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 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners 1 No.of Detection and
Initiatine Devices
No.of Ranges 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/Alertine Devices
No.of Dishwashers 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 1 KW No.of No.of Ballasts Data Wiring:
Heaters Sins No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
i 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: Christopher R Swift
Licensee: Christopher R Swift Signature LIC.NO.: 37071
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 8 PINE TER, E SANDWICH MA 025371432 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
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" Occupancy and Fee Checked
, ` BOARD OF FIRE PREVENTION REGULATIONS 1/07 Rev.
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APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CMR 12.00
i (PLEASE PRINT IN INK OR TYP ALL INFORMATION) Date: 4 6 l a
City or Town of: r i)( - To the Inspector of Wires:
By this application the undersigned g. es notice of his or her intention to perform the electrical work described below.
Location(Street&Number) ( `-a COX i i k( Cat..
Owner or Tenant Paw &ect,c I Telephone No.
Owner's Address !LA Car4-br COcL
Is this permit in conjunction with a building permit? Yes C No Ef (Check Appropriate Box)
Purpose of Building ,T(j I I'\.,��j Utility Authorization No.
Existing Service Amps / J Volts Overhead n Undgrd No.of Meters
New Service Amps / Volts Overhead C Undgrd C No.of Meters
Number of Feeders and Ampacity
t
Location and Nature of Proposed Electrical Work: t,C.11 re i i- u -f.
*., a.' (-C1.. r`l.tJt I.l. y[¢.V fl t' .Y
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
C\
No.of Luminaires Swimming Pool 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
lt( No.of Ranges No.of Air Cond. TotaTons
No.of Alerting Devices
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❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW 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: 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 permit issuing office.
CHECK ONE: INSURANCE +[]' BOND 0 OTHER 0 (Specify:)
I certify,under the pa; and penalties of pe 'ury',that the information on this application is true and complete.
FIRM NAME: li lir( S' c in3 t r"t LIC.NO.: ?,•
Licensee: C.—.-. - Chin C (;,..)...R-- Signature '"`-' ------- LIC.NO.:
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: S 0.P - E 5 -1 e
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 insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$