HomeMy WebLinkAboutBLDE-23-000352 Commonwealth of Official Use Only
_, ,4 Massachusetts
Permit No. BLDE-23-000352
,
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:7/21/2022
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) 6 COLBURNE PATH
Owner or Tenant CLARKE WAVERLEE WILLIAMS Telephone No.
Owner's Address HARWOOD GERALD, 6 COLBURNE PATH,WEST YARMOUTH, MA 02673
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: Installation of generator
Completion of the following table may be aived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans N Total
No.of forme </0 KVA
No.of Luminaire Outlets No.of Hot Tubs Generators rY A 10
AboveINo.of Emerg : + ! 4* r
No.of Luminaires Swimming Pool0
grnd. 0 grnd.n- Battery Units
•
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS '�t. ,A.es
No.of Switches No.of Gas Burners No.of Detection and O
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons 4
No.of Waste Disposers Heat Pump Number Tons _ KW No.of Self-Contained
4Totals: Detection/Alerting 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 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: Charles K Swanson
Licensee: Charles K Swanson Signature LIC.NO.: 12895
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 718 CEDAR ST,W BARNSTABLE MA 026681300 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. PERMI FEE: $50.00
1{ `.01 �-�f c �� 8(q2Avr6
- . _� _ Commonwealth o/�asjacLett9 Official Use Only
�7 Permit No.
3
Thepartment° ire Serviced
•=_i{_ Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
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: -7/6i2.1_
City or Town of: Yatmou*4tt 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) (p Cabu:Me PAN
Owner or Tenant Waves-we, W i1\ia y Telephone No. 508-292-8c, {
E Owner's Address Co CokloldXYV- Pa.%
vIs this permit in conjunction with a building permit? Yes n No n (Check Appropriate Box)
d Purpose of Building Utility Authorization No.
9qq Existing Service too Amps / Volts Overhead 171 Undgrd❑ No.of Meters
'ULG New Service Amps / Volts Overhead ❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
d Location and Nature of Proposed Electrical Work: wirinci of lb Kw generator
..--c
J
`ems' 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 1 KVA
No.of Luminaires Swimming Pool Above r-i 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 No.of Alerting Devices
Tons
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 DiMunicipal ElOther
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 f No.of Motors Total HP I 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: 01200 (When required by municipal policy.)
Work to Start: if25f22. 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 cov rage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE Ell BOND ❑ OTHER ❑ (Specify:)
I certify, under the pains and penalties of perjuty, that the information on this application is true and complete.
FIRM NAME:Clna;C eS K.Sc a on V8A Robes H2pkirt i. J-, LIC.NO.:
Licensee: C,\AL0(\2S K. $Wos‘S(X1 Signatur�,�-� .NO.: I'Z S A
(If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: %d_77 - '6
Address: 2141 Yoxcc c n Rci --V{cxhnis 0210o1 Alt.Tel.No.:
*Per M.G.L. c. 147,s. 57-61,security wbrk 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: $