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Home My WebLink AboutBLDE-23-005363 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-005363 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:3/30/2023 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) 5 CIRCUIT RD Owner or Tenant HOWDYSHELL CARINA NICOLE Telephone No. Owner's Address SMITH ELIZABETH MARY, 5 CIRCUIT RD,WEST YARMOUTH, MA 02673 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 ❑ 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: Conversion of porch to bedroom. 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 Initiatine 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/Alertine 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 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: Isaiah L Bassett Licensee: Isaiah L Bassett Signature LIC.NO.: 40515 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1362, BREWSTER MA 026317362 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 Rc iiv —fie J ) C,t, I N - /t O1 FAAIL I(,NA vl1,(� (CA r7i (� c t'-/Arwek4r. tSe "3tvfit✓ PtAt Jyt;16) (0/Jl Zs (l RECEIVED C ��IIq/y)m moneueahh o//11n4.4Oc '" Official Use Only c* eZ3 3,3 "� �� ` 0 2023 cc�� c�77 Permit N is 2epar�nent of .tire Serviced £-r8 Occupancy and Fee Checked B A f 4 ok!43�QAR O FIRE PREVENTION REGULATIONS [Rev. 1/071 By: _ _._._.. ! (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C).5 7 CMR 1'00 (PLEASE PRINT IN INK OR PE ALL INF RMA77ON) Date: `� 27 3 City or Town of: (' (,(, To the Inspector of Wires: By this application the undersign d gives notice of his or her intention to perform the electricall work described below. Location(Street&Number) 5c t fri 41�- �(/'c�S+ >?( U Owner or Tenant V)i't.Ot e r.cl,r t`h,/-) Howl7fineli Telephone No. 5-0 -c,% - 11,6S Owner's Address S L j r iA r' 1- DJ s f.- y Cl I'm es 041,1 Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building '1)j(n t 1 ,W otti5(: Utility Authorization No. Existing Service l/ Amps 106 / Volts Overhead 52K Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 61.1 G1 el,c`_L' For cv.1 t 0 a 6 P/j roc/m th rect 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('and. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Space/Area Heating KW w Detection/Alerting Devices No.of Dishwashers Local 0 Municipal 0 Other v—� - Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW Signs Ballasts Data Wiring: 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: fJ (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 ft--- 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 pe n),2itissuing office. CHECK ONE: INSURANCE 2 BOND 0 OTHER 0 (Specify:) $ i-AVc 441 5, I certify,under thejjains and pen 'ties of perjury,that the information on this application is true and complete. FIRM NA I�tt l, .$71 Ye Ie et LIC.NO.: aAi l f Licensee: ` =SoliaCt Lu _ e..'t} Signature) el...t,— LIC.NO.: A.CiA1 /1 (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: Lic.No. 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $