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Home My WebLink AboutBLDE-23-004954 "---' Commonwealth of Official Use Only � y d`�\� Massachusetts Permit No. BLDE-23-004954 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:3/9/2023 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. Location(Street&Number) 9 CAPT NOYES RD Owner or Tenant NICKY FULCHER Telephone No. Owner's Address 9 CAPT NOYES RD, SOUTH YARMOUTH, MA 02664 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: Remodel bathrooms&add smoke detector 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: 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: Heates 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Roland W Bassett Licensee: Roland W Bassett Signature LIC.NO.: 39692 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:46 JAMES BURR RD, BREWSTER MA 026312260 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 I k)-4cL.t ,t4 ,b,( rt N -t, Sir7(13 . rRFCElvEDI "i` �^5nl.an iw [[�i o� !//w�ac�eufell� Official Use Only � MAR 0 8 20 / Permit No. �`2 — �C S� y (_ ep G nl o1 Dire _cfrice.t `Y '�P T T Occupancy and Fee Checked '� ', ul��l� lit P EVENTION REGULATIONS P y 'y y 4 (Rev. I/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C e(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,?�/R City or Town of:,X 'i ck5141 WSIPER 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 ' � Owner or Tenant" - 1evi V"CC'til C . Telephone No. Owner's Address-"--i, As d .-fl/- Is this permit in conjunction wi a building permit? Yes....1X No ❑ (Check Appropriate Box) Purpose of Building F-e' Utility Authorization No. Existing Service/00 Amps ,%e'O / &mVolts Overhead Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity J `��l Z,m,,,/� .r at -- Location and Nature of Proposed Electrical Work: .5-/ f f ��: �, C'�fauw Completion of the following table may be waived by the Inspector of Wires. No. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans KVA Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No. of Luminaires Swimming Pool grnd. ❑ mod❑ 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 Total No. of Ranges No.of Air Cond. Ton No.of Alerting Devices No. of Waste Disposers Heat Pump Num¢e[ , Tons KW No.of Self-Contained Total: 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 No.of No.of Data Wiring Heaters KW 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 VERAGE: 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 ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,,that the information on this application is true and complete. FIRM NAME: • ram.:/, ^L' " , g t LIC. NO.: 39'6c1.2 G. Licensee: ", 11/ ''".,�' Signature cI LIC. NO.: .3`I69'2 e. (If applicable enter"exempt"in the license number line.) Bus.Tel.No.:??y&'Itj_6/U;� Address:;! /57• / ' e�, t ,Vf—/.'7 6j,.w; •,' 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 nor 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: $