HomeMy WebLinkAboutBLDE-23-003177 Commonwealth of Official Use Only
I Massachusetts Permit No. BLDE-23-003177
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:12/8/2022
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) 310 SOUTH SHORE DR 0"
Owner or Tenant SAFFORD HOWARD I Telephone w
Owner's Address SAFFORD MARY JO, 92 JUNIPER RIDGE DR, FEEDING HILLS, MA 01030-154
Is this permit in conjunction with a building permit? Yes 0 No 0 (Chec' t'•' : e .
Purpose of Building Utility Authorization No. O
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of • " •
New Service Amps Volts Overhead ❑ Undgrd 0 No.of M. • s Q /'�
Number of Feeders and Ampacity /
Location and Nature of Proposed Electrical Work: Install transfer switch for 60 amp generator with trickle charger.
/:.\,- !
Completion of the following table may be waived by the fnsp`ector 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 1 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 ❑ 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 ❑ 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: Craig S Little
Licensee: Craig S Little Signature LIC.NO.: 24841
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:31 SYLVAN LN, FEEDING HILLS MA 010301707 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) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE: $75.00
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•=:•. F •Par `�. s' Permit No."�i 3
*Pin Serviced
I'I ? Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [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 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
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) j0 Gv 4,,,.P b,Z.
Owner or Tenant 1 7r s O•-cr ///t/1i"
Owner's Address gt 2 t ,To Telephone No.Cy/j .L y(�3 /3
Is this permit In conjunction with a building permit? Yea ❑ No
Purpose of Building ❑ (Check Appropriate Box)
Utility Authorization No.
Existing Service Amps / Volts Overhead
❑ Undgrd❑ No.of Meters _
New Service Amps / Volts Overhead
Number of Feeders and Ampacity ❑ Undgrd❑ No.of Meters
I Location and Nat a of Proposed Electrical Work: 2N 5 f.eI 7724,1 j[/
6dA- (Zo aY0 Sw/cc
u; /�rif"lAv1�L C/Cke/4J%+ / ,)ov thelGIt
° Completion of the followm;table in be waived by the Inspector of Wires.
W No.of Recessed Luminaires No.of Ceil:Sus. ZYo.o
.. p(Paddle)Fans Total
C' No.of Luminalre Outlets Transformers KVA
No.of Hot Tubs Generators KVA
-t No.of Luminaires Swimming Pool Above Inn
n- No.of Hmergency Lighting
rod. nd. 0 Batte Units
No,of Receptacle Outlets No.of Oil Burners
FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o.o etec on an
No.of Ranges Initiating Devices
No.of Air Cond. rota' -
Tons No.of Alerting Devices
No.of Waste Disposerseat ump um er ors _ o.o e onto ne
Totals:
No.of Dishwasher Detection/Alertin Devices
Space/Area Heating KW Local un ce i
No.ofD ere Connection ��'
rY Heating Appliances Kµ, ecu ty ystems:
o.o H a[en ICW °o 0 o No.of Devices or Equivalent
SI ns Ballasts Data Wtring:
No.of Devices or E uivalent
No.Hydromassage Bathtubs
No.of Motors Total HP c ecommun ca ons r
OTHER: No.of Devices or E uivna�ent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: 23'00 c'
Work to Start: �-t0 (When required by municipal policy)
Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE OVERAGE: 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 enailies of perjury,that the lnformarfon on this application is true and complete.
FIRM NAME: /u4 h 0' /A'a i
Licensee: C4 j�LI LIC.4,
Signature LIC.NO.:
(If pplicable,a er"esempt' he/i a rum er line.)
Address: / m ` rydz ig (d G( i��e, `�. da„,,,D Bus.Tel.No.u)�`�7J`7
Per M.G.L.c.147,s.57-61,security work requires Department/ Pu lic SafetyS"License: 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 signature below,I hereby waive this requirement. I am the(check one owner owner's a ant.
Owner/Agent
Signature Telephone No. PERMIT FEE:$
17113- 0,2cy- g7,7