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HomeMy WebLinkAboutBLDE-23-000826 or Commonwealth of Official Use Only f. ,I Massachusetts Permit No. BLDE-23-000826 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:8/16/2022 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. //�pp Location(Street&Number) 26 ROSE RD 1 71/-- ZtPD - / CO lj Owner or Tenant ELDREDGE THEODORE R Telephone No. Owner's Address OBRIEN SIOBHAN E, 26 ROSE RD, SOUTH YARMOUTH, MA 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 ❑ 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 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 ❑ Municipal ❑ Other: Connection No.of Dryers 1 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: $155.00 Rz„._.EEo 7s 1 AUG EIV 16 2022 At� Massachusetts l.amm m oneaah.a`///assachusetts flOfficial Use Only 1/t BUILDIRJG DE. u.. 4-' Permit No. 6/DE - -10022k; _, j JJeParinunt olJ'in Services C) BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked - v [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Vi All work to be performed in aceadmce with the Massachusetts Electrical Code(MEC),527 CMR 12.00 U (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: --/ --2u 2 2_ City or Town of: YARM OUTH To the Inspector of Wires: By this application the undersigned gives notice ofhis or her intention to perform the electrical work described below. % Location(Street&Number) 2 fR O SP_ J. S. YG,!/h,,„/j-i /vlc;S O 2 4/q U Owner or Tenant 7;4,...,,,,/,....,re:, Ipj -/,�,e oi ,� Telephone No. U Owner's Address 26 7`/"Z�sr /rJnS— /QoSc ��. S� '/yr.ti m„� I't't n �2 E•G'1--/ Is this permit In conjunction with a building permit? Yes ❑- No 0 (Check Appropriate Box) Purpose of Building a/1,4 /`o ni✓1 ci.•%'ft,r, Utility Authorization No. CI- Existing Service S-/l©Amps 2/(0//ZO Volts Overhead my Undgrd g ❑ No.of Meters Of New Service Amps / Volts Overhead❑ Undgrd __g ❑ No.of Meters Number of Feeders and Ampacity / n I/ \� • Location and Nature of Proposed Electrical Work: ZC IS e S t R„,,,, 5.7 G O'/h v r"Tit tii c) O? 6I/5,Fti�c'n m I), Ro'a.,¢,`t vd ' Completion of the followingtable m9,be waived by the Inspector of Wires. of lb No.of Recessed Luminaires No.of Cell-Sap..(Paddle)Fain To.Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA �' No.of Luminaires Y Swlmmin Pool Above In- 'No.of Emergency Legating g send. G grad. ❑ Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Detection and {' 2 No.of Gas Burners Initiating Devices • 111 No.of Ranges No.i f Air Cond. ToTonsl No.of Alerting Devices Na of Waste Disposers Rat Pump Number Moos KW No.of Self-Contained Totals:1. '1_-'" '"-"`-..'-._.-__.. Detectton/AIerYLy 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' No.of Data Wiringvlea or Equivalent Heaters Signs Ballasts No of Devices or Equivalent Na Aydromaaaage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: p Attach additional detail tfdeslred,or as required by the Inspector of Wires, Estimated Value of Electrical Work:,V7) (When required by municipal policy.) Work to Start:V-2 U Z0Z Zlnspections 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)Specify;) • I rerdfy,under the pains and penalties ofpet'ary,that the Information on this application it true and comp/der FIRM NAME: Licensee: LIC.NO.: Signature LIC.NO.: (If applicable.enter"exempt"In the l cense number line.) Address: Bus.TeTel l.No.:_ °Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License:AIL Lic.No..--_ OWNER'S INSURANCE WAIVER: fain aware that the Licensee does not have the liability insu.. e coverage normapy required by law. By my eignnture be hereby waive this requirement. I am the(check one C owner ■owner's a:ent. Own tune / % -- _ 7 Signature /��,�7/�,�? �%Tek hone No, 7t/26(f-/moo P PERMIT FEE:$ 7 5;po Commonwealth of Official Use Only t 4+41 Massachusetts Permit No. BLDE-23-000826 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:8/16/2022 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 Blow. y � Location(Street&Number) 26 ROSE RD ! ( � t-j I C) 0`J Owner or Tenant ELDREDGE THEODORE R Telephone No. Owner's Address OBRIEN SIOBHAN E,26 ROSE RD, SOUTH YARMOUTH, MA 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: 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 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 1 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 1 RECEIVED �� kr \ s AUG 16 2022 B U f LD i Gut �' 1 ComnsonwaaGth o "ta ach o. Official Use Only//� BY l+iT "L- V 8 2t 18 ,h -- cc�� .c'} nn Permit No 1 .; ..CJepartmgnt Of.}irs Jirvrc*e t Occupancy and Fee Checked v ,j_, ;'' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) '', APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK v All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 U (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -/ —20 Z 2 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) / i,Se ✓ d < y,,. ,i,i„, ,r, M 4 5- G 2 9 U Owner or Tenant -77) ry ���,'' f; 7�l e Telephone No. 7 U 'e p 7Y-Z6.� _�vn5— 1 Owner's Address 2 lv fj e,s,- R.r, 5. Yam;,- v, /, l't't t c.- 2 t, C y Is this permit in conjunction with a building permit? Yes �'' No CD (Check Appropriate Box) L x. • IN Purpose of Building /,4 c„.,o c1.`„/,/ ,,L,t ,- Utility Authorization No. i- Existing Service f'5-/l1 U Amps 1/49//Z t. Volts Overhead aUndgrd[I] No.of Meters f New Service Amps / Volts Overhead El Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 26 A,S r. j2 $ y' J/ °w A.4/' Completion of the following table ml be waived by the Inspector of Wires. tik No.of Recessed Luminaires No.of Cell:Sas No.of- Total n,/ p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA t;:' No.of Luminaires 1/ • Swimming Pool Above ❑ In- No.of Emergency Lighting Receptaclegm& grnd. ❑ Battery Units a No.of Outlets No.of OH Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners -No.of Detection and Initiating Devices t:. No.of Ranges No.o Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons j KW -No.of Self-Contained Totals: ""' ' -"'" I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LocalMunicipal 0 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 Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Value of Electrical Work: 7I 0C C`> (When required by municipal policy.) Work to Start: J-2c! -2'2 ZInspections 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: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable.enter"exempt"in the license number line.) Bus.Tel.No.Address: TNo.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"License: Alt.Lie.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurapce coverage normally required by law. By my signature bel. I hereby waive this requirement. I am the(check one)( owner 0owner's agent. Owner/Agegj j /, /,,. Signature / %l/G Telephone No.77V 2(rtf-/o o 51 PERMIT FEE:$ -/, J c) I