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Home My WebLink AboutBLDE-23-004674 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-004674 4 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 Codc (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:2/23/2023 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) 61 PHEASANT COVE CIR Owner or Tenant WIGGINS ANN K Telephone No. Owner's Address 3633 CLIFF RD, BIRMINGHAM,AL 35205 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: Small addition Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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. Tons Tota No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Space/Area HeatingLocal ❑ Municipal No.of Dishwashers P KW Connection ❑ Other: HeatingAppliances No.of Dryers PP 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 Eauivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. required bymunicipal policy.) Estimated Value of Electrical Work: (Whenq P p y' 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: Jack W Griffin LIC.NO.: 418 Licensee: Jack W Griffin Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:26 JOANNA DR,S YARMOUTH MA 026641339 *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 I PERMIT FEE: $75.00 I Signature Telephone No. Zvati 23 E . 14,1,0,4_,, ? it 3 l z3 h Commonwealth of Massachusetts Permit No.: O is e Only, * t Department of Fire Services Occupancy and Fee Checked: =�j= BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/2023] v: APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 527 CMR 12.00 City or Town of: YARMOUTH Date: .2/3e12.3 To the Inspector of Wires:By this applicatio the undersigned gi es notices of his or her intention to perform the electrical work described below. Location(Street&Number): 6 ' Ph61A.S, io (j ift_ f2.0 Unit No.: Owner or Tenant: /' ob 71 4 N NQ (v 1 S/I» S Email: Owner's Address: 5,9".. - Phone No.: Is this permit in conjunction with a building permit?(Check appropriate box)Yes❑ No❑Permit No.: Purpose of Building: Utility Authorization No.: Existing Service: Amps / Volts Overhead❑ Underground❑ No.of Meters: New Service: Amps / Volts Overhead❑ Underground❑ No.of Meters: Description of Proposed Electrical Installation: ,,Syrl,p /f A19�r-bry Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: Generator KW Rating: Type:. No.Luminaires: No.of Recessed Luminaires: No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System 0 No.of Devices: Swimming Pool:In-Grnd.❑ Above-Grnd.0 Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System 0 No.of Devices: No.Air Conditioners: Total Tons: Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storage Rating: Security System 0 No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount 0 Level 1 ❑ Level 2 0 Level 3 0 Rating: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy) Date Work to Start:021 0.3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: �G,c k ere-(1-4 A-1 0 or C-1 0 LIC.No.: Master/Systems Licensee: LIC.No.: Mg IPS Journeyman Licensee: LIC.No.: 6 ‘.2.5.-9/7 Security System Businesfquires a Division of Occupational Licensure"S" S-LIC.No.: Address: e2 6 —J p A ni^1-4 01 ._ S S:e�Yjaii /L/jEmail: �a-c-k- C-1 7-(i,� &-1 e C/,f) �. (�MCoS/". n 7' Telephone No.:. 92 5'79 ,25c2/ I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: J(--C'' , 6-it f ' Print Name: Cell.No.: INSURANCE COVERAGE: Unless waived by the owner,n' . i or the performance of electrical work may issue unless the licensee provides proof of liability including"co ,leted operation"coverage or's substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof of s. e to the permit issuing office. CHECK ONE: INSURANCE L, BOND❑ OTHER❑ Specify: 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: Tel.No.: Signature: Email.: