The URL can be used to link to this page

Home My WebLink AboutBLDE-22-002529 ofA` Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-002529 �'°'�».. 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:11/3/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform t ee eh�ectrica!work described below. Nei4. p"`I Location(Street&Number) 7 DUFFY RD � Owner or Tenant Joshua Field 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: Bathroom addition 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 4 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- I: No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 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 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 -04 _11J9,)/ p - 75 a& Commontvea// al Maedachudafid Official Use Only c 0 e'er nt �CJsparf`nunt eight:Serviced Permit No. ��,��t?i� 2`� Service +, -. c— v 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 CMP.12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I i 12/2 I 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. vLocation(Street&Number) )- IJJ�,y a a ( 'Y�,J A14 ci 4 �? t Owner or Tenant 3 Est- ,.K -(—(,Ll'(/ Telephone No. ?. Z ,3a(el3 A Owner's Address y,4 M E Is this permit conjunction with a buildingpermit?� in Yes Er No 0 (Check Appropriate Box) Purpose of Building ) ?4i, .^'t Utility Authorization No. T Existing Service ;/ Amps / Volts Overhead 0 Undgrd g 0 No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters 1� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: //u i-lA rt,v aJJ/ ' r `) vl Completion of the following table may be waived by the In vector of Wires. No.of Recessed Luminaires 7No,of Ceil:Sasp,(Paddle)Fans No.of Total r / Transformers KVA el `-( No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires q Swimming Pool Above r-I❑ In' No.of Emergency Lighting -47 grnd. grnd. ❑ Battery Units ! No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS ,No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and t k r Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump iN umber Tons KW No.of Self-Contained Totals:l 4 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW "cal 0 Municipal No.of Dryers Connection 0 ��' zY Heating Appliances K`,i, Security Systems:* No.of Water , No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.flydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: ig. (When required by municipal policy.) Work to Start: j 1 2 f Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND 0 OTHER I certify,under the pains andpenalties o ❑ (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: Licensee: LIC.NO.: (If applicable,enter"exempt"fn the license number line.) Signature LIC.NO.: �` Address: Bus.Tel.No.: *Per M.G.L.c. 147,s.57-6 1,security work requires Department of Public Safety"S"License: LicAlt.Tel ______ OWNER'S I SURA CE WAIVER: I am aware that the Licensee does not have the liability insur:. ce coverage n —" required by la By signature below,I hereby waive this requirement. I am the(check one Owner/Agent C't owner ■ owner's a.ent. Signature Telephone No. Z Lp_ PERMIT FEE:$