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Home My WebLink AboutBLDE-23-001261 • (t)Th Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-001261 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:9/9/2022 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) 398 LONG POND DR Owner or Tenant PATRICE SCARUALONE 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 ❑ No.of Meters _ New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel basement&bathroom. Completion of the following table may be waived by the Inspector 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 Inttiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Cons 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 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Hens No.of Devices or Euuivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 0 (Specify:) /� I cernfy,under the pains and penalties of perjury,that the information on this application is true and complete. 77V 2. 722.-3I 25 FIRM NAME: LEON KNIGHT Licensee: Leon Knight Signature LIC.NO.: 20979 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:9 PILGRIMS WAY,BREWSTER MA 026312061 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 (Fivi r, tfrobs Vigb.a t/ ar 4•1� ,_, cA64--a ,-7 RECEIVED 12 -ectd¢Lt jvr fLoL1� SEP 08 20 ", Commonwealth olseeachuaa((d �O"ffic�ial Use Only •HN='lit as c� �7 �7 Permit No. �Urpartmant 0/.kr Seruicse BUILDING DEPA r� - . -, Occupancy and Fee Checked ey: -- y`i '.k,�,s 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 y(M ),527 MR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: y f2-2_ City or Town of: YARMOUTH To the Inspector of ires: By this application the undersigned gives notice f his or her. _ ion to perf a electrical work described below. Location(Street& be I3 qg' F 0 `Z 2 Owner or Tenant `/i((,Q C"r l on . Telephone No. Owner's Address f Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters fNumber of Feeders and Ampacity l Lo ation n Nature of Proposed EIe rical Work: r / b all\i/Y:),9 Als f ag se,i4A A4 r-n n"IA 4i Y �s• Completion of the following.table m be waived by the Inspector of Wires. IA,'! No.of Recessed Luminaires No.of Cell:Sas . No.off Total p (Paddle)Fans Transformers KVA r:t No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,I 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 1No.of Zones s. No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number!Tons f K�V No.of Self-Contained Totals: j 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munonnectioicipal n 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.No.of Water , Heaters Signs Ballasts'No.of No.of Data Wirinevices or Equivalent 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: 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 ❑ OTHER ❑ (Specify;) I certify,under thins and p nal ies o Rerjury that the information on this application is true and complete. FIRM NAME / �1 r /p '1—/C//yt p LIC.NO.: 7 Licensee: f 67 G t Signature/ , • (ifapplicable, ter ' n t"in All rider line.) LIC.NO Address: fti/f'yl f� (��iri �. �f.` R g2.631 us.Tel.No.•_ .� . ; it *Per M.G.L.c. 147,s. -61,security work re Tres Department of Public'Safe °`5"License: Alt.Tel.No.: 2- OWNER'S INSURANCE WAIVER: I am aware that the Licensee Lin.No. 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 agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ 7 I