The URL can be used to link to this page

Home My WebLink AboutBLDE-23-004324 - /4\ Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-23-004324 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:2/6/2023 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. ��pp -^^�� }7 Location(Street&Number) 60 WOOD RD f `6 ;G�. ( -3 / /3 Owner or Tenant SCOTT REID Telephone No. Owner's Address 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&bath remodel. Mini split heat pump and panel upgrade 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 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: 1 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 1t-� 3f M 7(z RECEIVED "h, o .6A 0/m44tiac tie Official Use Only .� _ B 0 3 2023 �� Permit No. LA 3 2-4 — �` LIE and Fee Checked l'��' �►Kur I E PREVENTION REGULATIONS Reev. i/4�ry ;‘,0'--* '-_----- � � leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( ),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 01/3/1/P'2,7 City or Town of: c '�� 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 0 wide,/ RI Owner or Tenant Telephone No.Se)K2 y/-3`223 Owner's Address `0 h' t/A , Iry Isz'.-s,ct,,p , . . O,26 f Q.▪ Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) _.c.E Purpose of Building Utility Authorization No. • Existing Service /00 Amps / / Volts Overhead 2- Undgrd 0 No.of Meters } v)I J -.) New Service Amps I Volts Overhead ElUndgrd 0 Na.of Meters g Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ki k4 it ,L te ,-,, r,,,/f7, z ,/it, 1 t ri At rh.` 51/< h.c'u f if s' Completion of the followingtable m«y be waived by the! for of Wires. No.of Recessed Luminaires No.of CelL-Sins.(Paddle)Fans No.of �tal Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA e • Na,of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting mid. er&►. 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 1 t No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons _ KW 'No.of Self-Contained Totals: Detection/Aler�Devices No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other 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 Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsofDevices �g No,of Devices or Equivalent OTHER: Attach additional detail ifdesired or required by the Inspector of Wires. Estimated Value of Electrical Work: -2 j-!�'‘4' (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 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: Of applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Dr,. ,et of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability ins ce coverage normally required by law. By si true below,I h y waive this requirement. I am the(check one) owner 0 owner's agent. Owner/Agenttune � -`� / Signature � �� ✓ Telephone Na.)-08-2%/-329.r PERMIT FEE:$