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Home My WebLink AboutBLDE-23-004172 Commonwealth of Official Use Only t. Massachusetts Permit No. BLDE-23 004172 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:1/27/2023 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) 11 DANBURY ST Owner or Tenant KEITH CHAMBERLAIN Telephone No. Owner's Address 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: Kitchen&living room remodel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 10 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 14 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 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/Alertine Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ 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.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: David M Hawkins Licensee: David M Hawkins Signature LIC.NO.: 31112 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN, YARMOUTH PORT MA 026752252 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 - � RECEIVED .�. t o m huadis Official Use Only AN 2 6 2023 """`� �` `� c v _ 3 - 7'..,�,B, ! Permit No. ,L ;, ,j 0�L s�,v� tI I ND DEPARTMEN Occupancy and Fee Checked — %PARD-.:OEF E PREVENTION REGULATIONS [Rev. I/07) (leave blank) V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / ;3� , City or Town of: ,mou To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. 1 Location(Street&Number) // A-A) e,L1to` `S s- _yV4aYI'!oc 44 Owner or Tenant K�1111 L- 1� 1 AV t 4_,..— ,,:Q.lR-l N Telephone No. Owner's Address 3'1'7 Cw itg7�PA-a k e D Jor4T`S i iN 6�4- t ciC�4,5 Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) 1 L Purpose of Building Utility Authorization No. Existing Service /b 0 Amps /2,0/ a y% Volts Overhead e Undgrd 0 No.of Meters J' New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity / pz:f.k.„:i--1) MT)f}-p,,. t ALocation and Nature of Proposed Electrical Work: K I r cl-)-i 1t i .j itt t. ' R Y1^,t7ts `f1 Completion of the following table m be waived by the Inspector of Wires. .oTotal No.of Recessed Luminaires /0 No.of Ceil.-Susp.(Paddle)Fans T Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ 'No.of Emergency Lighting g grnd. grnd. Battery Units No.of Receptacle Outlets if y No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No. Dete and � In Initiatinnggon Devices No.of Ranges / (....44 ., No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Disposers 'Heat Pump Number Tons._.KW No.of Self-Contained Totals: y Detection/Alertin Devices No.of Dishwashers I Space/Area Heating KW liars./❑ Connee n ❑ Other No.of Dryers Heating Appliances KW Security Systems:* �' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent tions Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Telec No. f Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: 9C'x) (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 OTHER 0 (Specify:) I certify,under the pains and penalties of pedury,that the information on this application is true and complete. FIRM NAME: 4, _ LIC.NO.: Licensee: b/j,iS yI,u / 4' Signature �, g ,tt ,tA,4 LIC.NO.: .?/J/ L= (If applicable,enter"exempt"in the license number line.) �/ Bus.Tel.No.: 7'151 a 1d O S'" Address: / / v A*,/,� y1ly l,d.,' L /✓ 7i 40 1 Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 PERMIT FEE:$ Signature Telephone No.