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Home My WebLink AboutBLDE-22-006171 -'' Commonwealth of Official Use Only • Massachusetts Permit No. BLDE-22-006171 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:4/27/2022 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) 7 SOPHIE ANNE DR Owner or Tenant DUDLEY BRIAN A Telephone No. Owner's Address DUDLEY REBECCA S, 7 SOPHIE ANN DR, YARMOUTH PORT, MA 02675-1431 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 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: Split A/C system. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 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 ❑ Municipal ❑ 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 ❑ 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: Jonathan R Hall Licensee: Jonathan R Hall Signature LIC.NO.: 11925 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:263 CAMMETT RD, MARSTONS MILLS MA 02648 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: $50.00 RECEIVED APR 2 6 2022 Com alth o////aadachuaa(fe Official Use Only ILDING DEPARTNT �c77 nn -, k , _ ______ of of ira Serokee Permit No.` /[-C -tt� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked _ 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) J City or Town of: YARMOUTH T� Date: � �� t�� By this application the undersigned givYAnotice RM his OUTHintention to perform tthe ele ect ical ector�kdescribed below. Location(Street&Number) 1 C, t� i _r Owner or Tenant Telephone No.77y 3 3 q Owner's Address Is this permit in conjunction with a building permit?Purpose of Building -4 Pe Yes ri No 12 (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New--SQ^'iCe Amps / Volts Overhead❑ Undgrd 0 No.of Meters r Number of Feeders and Ampacity f Ji Location and Nature of Proposed Electrical Work: vi tv Completion o the ollowin;table m be waived b the Inspector o Wit-es. ('I No.of Recessed Luminaires No.of Cell:Snap.(Paddle)Fans 'o•o ota t No.of Luminaire OutletsTransformers KVA No.of Hot Tubs Generators KVA -,i No.of Luminaires Swimming Pool • 'OVe n- 'o•o Unitsmerg g n �� •rnd. ❑ ! nd. ❑ Batte Units g No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones . - No.of Switches No.of Gas Burners `o.o 1 etec on an `4` No.of Ranges Initiatin 1 Devices No.of Air Cond. ota Tons No.of Alerting Devices 'eat `ump `um s er ons ' "o.o e - onta ne No.of Waste Disposers Totals: No.of Dishwashers Detection/Alertin• Devices Space/Area Heating KW Local Y.un op,No.of Dryers Heating Appliances ecu ❑ Connection ❑ Other `o.o "a er KW ty ystems: Heaters KW 'o•o .o o No.of Devices or E uivalent Si ns Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or Es uivalent No.of Motors Total HP a ecommun ca i ons " rmg: OTHER: No.of Devices or E•uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: � t' � (When required by municipal policy.) ��a��11 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 Er BOND ❑ OTHER I certi,fy,under the pains and penalties oIPer u that the information on this application is true and complete. r1', FIRM NAME: ;) Licensee: LIC.NO.: Signature (!fenseabte,enter exempt in the license number line.) =-�'------_.._ LIC.NO.: Address: d Alt.Tel.No.Bus.TelNo.:Sn.P- *Per M.G.L.c. 147,s.57-ti l,security work ures Department of Public Safety"S"License: : 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/Agent ❑owner • owner's a;ent. Signature Telephone No. PERMIT FEE:$