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Home My WebLink AboutBLDE-23-001847 Commonwealth of Official Use Only ,ifie lritii, Massachusetts Permit No. BLDE-23-001847 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:10/6/2022 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) 426 ROUTE 6A Owner or Tenant CHARLEY ROY Telephone No. Owner's Address 426 ROUTE 6A,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Boo' Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters 7� New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Kitchen and bath room remodel.Add sub panel. ,' 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 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 ❑ 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: LEON KNIGHT Licensee: Leon Knight Signature LIC.NO.: 20979 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 PILGRIMS WAY, BREWSTER MA 026312061 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 KitilelV4 . C/ 141 e t(3C0 (LIk 1 • 2ctiw3 utal ... .. L, ta . _ Plia-tr4 pilv-ECEQ6,-FA65 101(3 " 0:41 /A-a&6fa c/// -/v 0 R E .p E �," OCT 06 202� 4' ^`�/)/) / ° Qa[th I //laddacRadaild Official Use Only " ' ', t DING UtPART cc�� Serviced Permit No.• `` 7 nl of ire " BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ,,,, 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 R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /( 6 2 2- City or Town of: YARMOUTH To the Inspe for o Wires: By this application the undersigned gives notice of his or her intention to perf rm the electric* ork described below. Location(Street&Numer) J Owner or Tenant 0 Owner's Address,4 ' -) etill ' / �L.� Is this permit in conjunction with a buildiugppermit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead E Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed ect call cork:, '' ct/Ipt-lci rein c._-, e )? Completion of the fo owing able m be waived by the bisector of Wires. ‘is) p 11 No.of Recessed Luminaires No.of Cell:Sas . No.off Total .., p (Paddle)Fans Transformers KVA �.1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires • Swimming Pool Above ❑ In- No.of Emergency Lighting _and. grnd. ❑ Battery Units ;l No.of Receptacle Outlets No.of Oil Burners w FIRE ALARMS INo.of Zones tir- No.of Switches No.of Gas Burners No.of Detection and II! No.of Ranges No.of Air Cond. Total If Ale InitiatingDeviDevices Tons No.of Alerting Devices No.of Waste Disposers 1 Heat Pump Number Tons 1KW No.of Self-Contained Totals: [ 1 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 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 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: 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 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 BOND 0 (Speci ❑ OTHERty;) I certify,under the pains and p a al es of er ry at the information on this application is true and complete. FIRM NAME: / 2`k 1. P f -( �., //) F Licensee: _ j-' / LIC.NO.: �'� t • / SignatureAlf Address:able.77)erPf' "inn thelicens u r/mne•) t�� S �: LIC.NO.: 1�2S > ,,��^''.fr / Bus.Tel.No.•� �7J/ *Per M.G.L.c. 147,s. 61,security wo requi �Departrnen Public Safety"S"Li fiflcense: Alt.Tel.c.1No.: 7 !�`13 OWNER'S INSURAI'QCE WAIVER: I am awtl e 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 owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE:$