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Home My WebLink AboutBLDE-22-006894 .A Commonwealth of Official Use Only i Massachusetts Permit No. BLDE-22-006894 :Wa .' 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:5/30/2022 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) 368 FOREST RD Owner or Tenant Jeffrey Wright Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Purpose of Building Appropriate Box) Utility Authorization No. Existing Service - Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 of Meters Number of Feeders and Ampacity �' les / Location and Nature of Proposed Electrical Work: Convert garage into living room. Mgt i* Completion of the follow ltr4ue >ipector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No,of O Total Transform s Q KVA No.of Luminaire Outlets No.of Hot Tubs Generators <�� vA No.of Luminaires Swimming Pool Above 0 In- 0 No.of Emergency `'. /++// grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.o e9 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 f I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting 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 Devices or Equivalent 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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties operjury,that the information on this application is true and complete. .f FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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: S75.001 rL .jIVED— �,• MAY 27 202 �/j/) `� n luvaa // � O��//addachadaled Official Use Only q e ' f 1- Mt , p DING (�t PH R T M f~insn1 o�}i,t�irvicsd Permit No, Z , (�J . I ,s —BIIAItu of FIR REVENTION 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) se4 Code(MEC),527 CMR 12.00 City or Town of: YARMOUTH To the In y By this application the undersigned Ives not. Spector of Wiles: g gives of his or her intention to perform the electrical work described below. Location(Street&Number) ct t—ys�s4., i� Owner or Tenant Q��e73 (� Owner's Address _ Telephone No. 6�•i-6.',33 Is this permit in conju coon with a building • W. e.,✓'t/uo a 2•473 Ug permit. Yes No ❑ (Check Purpose of Building�oltNtr/�r ts llt+� �,st � Appropriate Box) -- Existing Service Utility Authorization No. Amps Volts Overhead❑ Undgrd❑ No.of Meters . New Amps / Volts Service Number of Feeders and Ampacity Overhead 0Undgrd El No.of Meters °� f Location and Nature of Proposed Electrical Work: kel 'fU Ll - Completiono the ollowin• table in be waived the Ins,ectoro Wires. No.of Recessed Luminaires No.of Ceil.-Sas . `o.o =;1 No.of Luminaire Outlets p (Paddle)Fans ota r4, No.of Hot Tubs Transformers KVA �' No.of Luminaires Generators KVA Swimming Pool ' 'ove n- 'o.e Units g mg '`` No.of Receptacle Outlets rod. � • nd. 0 Batte Units No.of Oil Burners No.of Switches FIRE ALARMS No.of Zones No.of Gas Burners `o.o I etec on an • ' No.of Ranges Initiatin. Devices No.of Air Cond. ota No.of Waste Disposers ump 'upper Tons No.of Alerting Devices 'eat ' ons ' ►• Totals: .................................................... o.o e - onta ne No.of Dishwashers Detection/Alertin• Devices Space/Area Heating KW Local T un cipa No.of Dryers Heating Appliances Connection other`o.o "a er KW ecur ty ystems: Heaters KW O.o .o o No.of Devices or E•uivalent Sins Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or E.uivalent No.of Motors Total HP a ecommun ca ons " r ng: OTHER: No.of Devices or E I uivalent Attach additional detail ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Stan: aO. OG (When required by municipal policy.) Inse d in INSURANCE COVERAGE: Unless pections to waived by the OCT,wn nopermit for the p perform MEC ance ele Utica on completion. the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The 1 work may issue unless 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 I certJfy,under the pains and penalties o ❑ (Specify:) FIRM NAME: 1perjury,that the information on this application is true and complete. Licensee: LIC.NO.:---- (Ifapplicable,enter••exempt"in the license number line.) Signature Address: LIC.NO.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safe Bus.Tel.No. -- Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have he liability insurance coverage normally law. B in signature below,I h by waive this requirement. I am the(check one Lic.No. Owner/Agent � owner y Signature v owner's a.ent. Telephone No. PERMIT FEE: $ _ ) 7 .?