The URL can be used to link to this page

Home My WebLink AboutBLDE-22-005909 Commonwealth of Official Use Only 'In Massachusetts Permit No. BLDE-22-005909 : ; BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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:4/14/2022 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) 33 QUARTERMASTER ROW Owner or Tenant JOEDENE LYONS Telephone No. Owner's Address 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: REWIRE MASTER BATHROOM,ADD LED WAFER LIGHTS, PLUGS AND • SWITCH ,ARC FAULT Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 25 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 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 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. romassa H d a Bathtubs 1 No.of Motors Total HP Telecommunications Wiring: y g 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MARK B KIEFER Licensee: Mark B Kiefer Signature LIC.NO.: 26093 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 53 GRASSY POND DR, DENNIS MA 026382515 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. I PERMIT FEE: $75.00 I a.,..k.)CeAk `4 17 '2Jt-.� 1 , RECEIVED i I % R2Q22 r�j // ° . nwsa[th ol///aedachuaaftd Official Use Only .'t:it'.�^ ,1G DEPARTMEN c� ��JJ Permit No. J , - �rG�s' i - 0_ spartmsnt o�,}iro Ja+vicsd a 1`1' BOARDO REGULATIONS F FIRE PREVENTION Occupancy and Fee Checked �_ y [Rev. 1/07] (leave blank) A APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 1.4 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 qi- (PLEASE PfIVT IN INK OR TYPE ALL INFORMATION) Date: 3 € (f- '164.9 or Town o City YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of h's or her intention to perform the electrical wor described below. A Location(Street&Number) U. i t2 Owner or Tenant `P ro 451 Telephone No. �t 07 Owner's Address.;'� q, es fr, a, Is this permit in conction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building key /Do")$14-r Utility Authorization No. Existing Service Amps / / Volts Overhead E Undgrd El No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: l '1 dD Completion of the following.table may be waived by the Inspector of Wires, it,; No.of Recessed Luminaires s No.of Ceil:Sus . No.of Total p (Paddle)Fans Transformers KVA rC.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,_l.. No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting rad. and. ❑ Battery Units ti` No.of Receptacle Outlets ': No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches /_ No.of Gas Burners -No.of Detection and i<< 'C7 Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters No.of KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs 1 No.of Motors Total HP Telecommunications Wiring; OTHER: No.of Devices or Equivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: � f,j (When required by municipal policy.) 3'-/� t Inspe tions 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 1 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. 0‘ ''' CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I certify,under the pains andpenalties o jperjury,that the information on this application is true and complete. FIRM NAME: Licensee: rC, e LIC.NO.: Signature LIC.NO.: (If applicable,enter"venrpt"in the license tuber line. Address: � 1 � E Bus.Tel.No.. *Per M.G. .c. 147,s.57-61,sec ity work requires Department of ublic Safety"S"License: Alt Lich No. --� o 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 0 owner • owner's t Owner/Agent Signature Telephone No. PERMIT FEE:$