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Home My WebLink AboutBLDE-23-004446 Commonwealth of Official Use Only ��_�tA� . Massachusetts Permit No. BLDE-23-004446 ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/07j 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:2/13/2023 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 electncal work described below. Location(Street&Number) 62 SILVER LEAF LN Owner or Tenant WARD HENRY JOHN Telephone No. Owner's Address WARD NORA,62 SILVERLEAF LANE,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Checropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd * iitt. , New Service Amps Volts Overhead 0 Undgrd ip. Number of Feeders and Ampacity G Location and Nature of Proposed Electrical Work: Remodel basement,washer/dryer,&add sub pane. Completion of the following table may a e e spector 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 Initiatine 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 Space/Area Heating KW Local 0 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 Siena No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total 111' 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 cerrify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MICHAEL D HOLLISTER Licensee: Michael D Hollister Signature LIC.NO.: 10071 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:85 N DENNIS RD,S YARMOUTH MA 026641017 Alt.Tel.No.: "Per M.G.L.c.147,s.57-6I,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 Signatures Telephone No. PERMIT FEE:$75.00 at ctry , /9(23 C Foe g0ofmn r, 0 1 �, mprii,,e asr e4 qti RECEIVED __ B 1 2023 0 •nivsaCth of Ma-6saci=u�afti - • Official Use On1 __:fit= _ l Permit No. %23 —4- 40 parimer`t of gu-a Serviced . _- -.ING DEPARTMENT - -- Occupancy and Fee Checked Y -= =--- Lei!. PREVENTION REGULATIONS {Rev. I/07J d D D t I n A T r r1 i 1 r"n,-� .-- . �- - - — (leave blank) -- . - . . tr�`1�1Tl_1 1 1 v rcrrvmm tLtL I KICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (PLEASE PRINT IN INK OR TYPE ALL B FOPJ U TTO N (ME ), s27 CMR 1 z_+�o ) Date: .2 /Q Z:3 City or Town of: YARMOUTH To the Inspector of Wires: By this application the pridersigned Fives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 60 , C y LEi.4'i Owner or Tenant /1 / Ng i A VII 4 e- 0 Telephone No / __ �� Owner's Address Is this permit in conjunction with a building permit? Yes Na ❑ (Check Appropriate Box) Purpose of Building V. E2 t I 95f' C Utility Authorization No. Existing Service �' �t)t2 Amps / Volts Overhead g Undgrd ❑ No. of Meters C ‹. New Service Volts Amps T F olts Overhead ❑ Undgrd E No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the_followine table m 'be waived � by the Inspector of Wires. No. of Recessed Luminaires No. of CeiL Susp. (Paddle) Fans No. of Total Transformers KVA L No. of Luminaire Outlet3 No. Hof Hot Tubs Generators KVA % No. of Luminaires Swimming Pool Above ❑ In' ❑ of Lmergency Lighting 1No. 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 J Initiating Devices No. of Ranges No of Air Cond. Total Z Tons No. of Alerting Devices No. of Waste Disposers Heat Pump I Number_ Tons KW No. of Self-Contained Totals: I -'- Detection/Alertina Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal other - tb Connection �. No. of Dryers ' Heating Appliances , Security Systems;* No. of Water , No. of Devices or Equivalent N Heaters KW 0• of No. of Data Wiring: t Sims Ballasts No. of Devices or E uivalent K No. Hydromassage Bathtubs No. of Motorsq Total HP Telecommunications Wiring: No. of Devices or Equivalent v^ OTHER: J Estimated Value of Elec Attach additional detail f desired or as required b the Insect tncal Work: _____9r.f_ U (When required by municipal policy.) y P or of Wires. Work to Start: p 2_ Inspections to be requested in accordance with th MEC Rule 10, and upon completion. CE COV RAGE: Unless waived by the owner, no permit for the performance of electrical workissue the licensee provides proof of liability insurance including "completed operation" coverage or its may ent. unless undersigned certifies that such coverage is in force, and has exhibitedproof of samesubstantial equivalent. The CHECK ONE: INSURANCE BOND to the permit issuing office. I certl under ther 0 OTHER ❑ (Specify:) fy, pains and penalties of perjury, that the information on this application is true an FIRM NAME; IC(-1'�-� d complete. �- 13 /'IUL,LtST LIC. NO.:_kL,Q_..r____L-_3 Licensee: qiIc..---lica �� c Signature LIC. NO.: (If applicable,ble, enter "exempt" in the license number line . Address: 4 I - Bus. Tel. No.: S / " Per M.G.L. c. 147, s. 57-61 , security work requires Department of PublicAlt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabili uric. No. , I hereby waive this requirement. I am the (check one ❑ ownercoveraoge normally required by law. By my signature below, ` Owner/Agent ❑ owner's a ent_ Signature - Telephone No. PERMIT FEE: S