The URL can be used to link to this page

Home My WebLink AboutBLDE-23-003576 Commonwealth of Official Use Only JPermit No. BLDE-23-003576 Massachusetts . BOARF 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:12/30/2022 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) 18 NICOLE AVE Owner or Tenant SCOTT EDNA R Telephone No. Owner's Address 18 NICHOLE AVE, 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 0 Undgrd ❑ 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: Wire playroom and office in basement. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 17 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 16 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 11 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 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: 01/02/2023 Inspection to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE:Unless waived by the owner,no pennit 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.: (lfapplicable,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 Ro1j3?Z E C,Ki0 -- (f tG'(v-JG w DEC 30 2022 a f C'°mm°nu'°aGth°l Official Use Only +`4t!l w�I�r I Pv C i E NA V<f M E aBeac adaffe — ! •,, PermitNo, E23 - 33 7(., f►nsni o/„rim-t�use ,, °' ?M Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. l/07] leave blank 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: I Z( 30 l L d at City or Town of: YA R M O U TH 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) N a,e n‘C vce Owner or Tenant , 1— "(*�wv, �" ��6`J1 -S ��' ' 0 k Telephone No. d Owner's Address l g iv;cot, -I1t} 4-0 8 06 d Is this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box) Purpose of Building D'.4J(ciao-, 1 o f-k''-ce Utility Authorization No. Existing Service 1 U Amps I l a /21to Volts Overhead v ❑ Undgrd No.of Meters �_ 5 New Service Amps / Volts Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: ?)0,y ,,l 1 ;rQ �� V � o� �tC,✓1^r�f- a, \r f No Completion of thefollowinktable m be waived by the Ins ector of Wires, ( - No.of Recessed Luminaires No.off t 9 No.of Ceil:Sasp.(Paddle)Fans Total 1 No.of Luminaire Outlets 5 No.of Hot Tubs Transformers KVA (z( Generators KVA `- No.of Luminaires 3 • Swimming Pool Above ❑ In- No.of Emergenc Lighting `1 No.of Receptacle Outlets rnd. nd. ❑ Batte Units }� l �, No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches I No.of Gas Burners o.o etec on an '1.f No.of Ranges Initiatin Devices No.o Air Cond. ot Ton as No.of Alerting Devices eat ump um er ons o.o e onta ne No.of Waste Disposers Totals: Detection/Alertin Devices 2 No.of Dishwashers Space/Area Heatingun c a KW � L'0ce l❑ Conne ction ❑ °tiler No.of Dryers Heating Appliances ecu f� KW ty ystems: o.o a er o o No.of Devices or E uivalent Heaters ' °•° Data Wiring: Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP e ecommun ca ons ring: OTHER: N°•of Devices or E uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: 1 2 (When required by municipal policy.) Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 ❑ OTHER [3 (Specify;) c),Qnc - I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: 7 , LIC.NO.: (If applicable,enter exempt"in the license number line.) Signature LIC.NO.:___ _��,��-- Address: "' --- Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage�normally required by law. By my signatu a below,I hereby waive this requirement. I am the(check one i;� owner Owner/Agent q • owner's a.ent. Signature Telephone No.224 Lt D a' (768j' PERMIT FEE:$