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Home My WebLink AboutBLDE-23-002747 ev�`� Commonwealth of°� '1 ,\. Official Use Only ... ,,,, MassachusettsPerrtitNo. BLDE-23 002747 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) City or Town of: YARMOUTH Date:T the Inspector of Wires. By this application the undersigned gives notice of his or her intention to perform the electrical work d scribed below. Location(Street&Number) 169 WOOD RD Owner or Tenant DEVLIN DOROTHY A Owner's Address DUMAS KEITH E, 169 WOOD RD, SOUTH YARMOUTH, MA 02664-4229elephone No. 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 New Service Undgrd 0 No.of Meters Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Rewire kitchen outlets. Remodel 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 VA K Transformers No.of Luminaire Outlets KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool g hove ❑ grnd ❑ No.of Emergency Lighting rnd. Battery Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts Signs Data Wiring: No.of Devices or Equivalent No.Hydromassage 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: (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 ❑ :) I certify,under the pains and penalties ofP J Y• er ur ,that the information on this application istrue and complete. FIRM NAME: Glenn W Crafts Licensee: Glenn W Crafts Signature LIC.NO.: 10020 (If applicable,enter"exempt"in the license number line) Address: 72 COUNTRY CIR, SOUTH DENNIS MA 026602920 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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. I PERMIT FEE: $75.00 s gtrS„4' 12/z'/JJ Ace) covurc.2.Axe. , 5 inoZ eu'city C,iZ i ' J//t, 1/, 7.2 r ((:00en tiev) frn - " 17 z3 E' ' Commonwealth of Massachusetts official Use Only __' +'=1' Department of Fires Services Permit No. 2�-Z7`-L7 ='�=+=a Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev.9/05) (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) Date: 1 L I L(" Z--Z--- City or Town of: ya,,INIA0 1, -G\___ To the Inspector of Wires: By this application the undersigned ves notice of his or her 'cntio ten to perform the electrical work described below: Location (Street�1,tuber) R Oc l.K)c c Owner or Tenant ('�vM"�k� - ��V\CJ �,� �'C�v k t ii\ Telephone No.7 7 LI _Z l Z '�(o y Owner's Addr'r s Z(0 C\ �r9a-R JI� ( ^ A s 7a l,1:14 0) C.Z-C.D(p Y Is this permit in conjunc 'on with a building permit? Yes Purpose of Building ( r6v0A.`k- (Check Appropriate Box) � Utility Authorization No. Existing Servi „ 'r c s• i l Volts Amps S � Overhead Undgrd ❑ No. of Meters New Ser.F:iKe Amps / Volts Overhead® Undgrd Number of F'eder-s and Ampacity El No. of Meters tQl Location and Nature of Proposed Electrical Work: e,.�s i`e t VAC,. k- +c (/.LA c'C' Ceivt/\O Ci4_( Completion of the following sable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Totwl No.of Lninlnaire Outlets Transformers Rye,, No. of Hot Tub's Generators KVA No.of Lumina-res swimming Pool Abo.,:-. ;-1 In- ❑ No.of Emergency Lighting No.of tte�efltarle Outlr45 �''?•._`---J grad. Bettcty unit, .. __ VY No.c f Oil Burners ^Fl k'Zly AT�111+;IS No.of 7,ottes Nc. 5r' Viic.es - No.of Cas Barnet-, No.of D tection and No 3f m 1tSres ' - ----- ___... Initiating Devices � pNo.of Air Cond. „tal No, of Alerting Derives No '" : '^Late Dispose:s Heat Pump Number Tons KW No.of Self-Contained Totals: ____._.._............._..._.._. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local El Municipp�al Heating A �otutedtlan ❑Other No.of Dryers _ g Appliances Kw Security&stems:* No.of Water No of Devices or Equivalent K Heaters W No.of No.of Data Wiring: Signs Ballasts No,of Devices or Equivalent No.Hydrorrtassage$athtub5 No. of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attached additional detail if desired,or as required by the inspector of Wires. Estimated Value of Electrical Work: "' 1 Work to Start e( ' 9 ri Z (When required by municipal policy.) �-Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no the licenseeN provides proof of liability insurance including own "completed permit for the performance of electrical work may issue unless undersigzied certifies that such coo ge is it•.force,and has ed proof of same to ation"coverage the permit issuing officeutvalent The CHECK ONE: INSURANCE I certify, ton aer the airs��; BOND❑ OTHER r' (S�,i.,.' d enaltie o ^�• k'R A ,�:A . : P f per7'ury,thr�1 the t z .t,t�urt a this application is tru and complete_ . � (ec ,C t .c_.. sip• (La at p b1-,c "e - t{ Z. � �r , the r.;-,.05,;number`' AddteW `ScL _ G1�4 c u c dl _.t v� 4 ,tit, ..N. 6T Bus.Tel.No.clL( *Security System Contractor License required for this work if S AIL her 1.No.: OWNER'S INSURANCE W applicable,enter the license number here; requiredOWNS by law.ByWAIVER:I am aware that the Licensee does not have the liability insurance coverage normally my signature below thereby waive this requircmient.I am the(check one) ❑owner , • Owner/Agent Downer's agent Signature Telephone Na. PERMIT FEE:$