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Home My WebLink AboutBLDE-23-001255 •!�* y / Official Use Only Commonwealth of Massachusetts Permit No. BLDE-23-001255 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: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) 9 MORNING DR Owner or Tenant ROCKSTROH CARL E Telephone No. Owner's Address ROCKSTROH PAULA J, 7055 OWLS NEST TERR, BRADENTON, FL 34203 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 0 Undgrd 0 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: Rewire kitchen, Hallway, &2nd floor bedroom. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 8 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 12 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 0 Municipal ❑ 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 0 BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: STANLEY D ANDREWS Licensee: Stanley D Andrews Signature LIC.NO.: 15248 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:201 HEAD OF THE BAY RD, BUZZARDS BAY MA 025325640 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 F /242-3M___—= 14 Commonwsa[tk of 11Jaseuuest chte Official Use Only ok, cc�� c7 {{�� Permit No. to , a �Llspartawsl oi tins Jsrvicse i . Occupancy and Fee Checked `� BOARD OF FIRE PREVENTION REGULATIONS [Rev. t/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code E ),527 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: , //a./ 2 a_ City or Town of: 'c' v��>u' To the Inspector of Wires: By this application the undersigned hives notice of his or her intention to perform the electrical work described below. Location(Street&Number) (A O ,pj'yNS&cj) ' Owner or Tenant Co.,<1 1 �//r`i Q'1 Telephone No. Owner's Address 7O3 01.,,, 's Al 4 404 T,e 1' ,1: IN' 11,4 n047-+• F 2. 31/Z2( 3 Is this permit in conjunction with a building permit? Yes No Li (Check Appropriate Box) • Purpose of Building b--�e I I r---1') Utility Authorization No. L. Existing Service ,,la 0 Amps t kUl 'Ye/Volts Overhead 3a Undgrd No.of Meters tV New Service Amps / Volts Overhead E Undgrd No.of Meters jNumber of Feeders and Ampacity •--Q Location and Nature of Proposed Electrical Work: e ,we llc,E Lt SI 1-1.j( ,.J..w/ j ,)- ''.*-/oe-r,,e�„ Completion of the fallowing table may be waived by the/nslector of Wires. Total No.of Recessed Luminaires F No.of Cell:Susp.(Paddle)Fans Trraann KVAf Transformers +t No.of Luminaire Outlets No.of Hot Tubs Generators KVA ,,,. No.of Luminaires SwimmingPool Above ❑ In- ❑ Bate ,Units Lighting grad. grad. Battery Units ' No.of Receptacle Outlets )gi No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6' No.of Gas Burners No. Detetioa and �^i Initiating Devices I I RangesTons£ No.of No.of Air Cond. Total No.of Alerting Devices Pum _ .1siti.of Self-Contained No.of Waste Disposers Heat Totals Number Tons ' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Nesting Appliances KW Secustems:* No. f Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of lectrical Work: (When required by municipal policy.) Work to Start: /4,2Z 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 [2c BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties of petjury,that the information on this application is true and complete. FIRM NAME: ,t ✓zz.tr,,'/5" b, Eleed.,eC LIC.NO.: /5-.2yS' Licensee: •5 4,..t.It'y 0 %g i'+.(.1 t`-'�� Signature 2."z 1c- C'�"� LIC.NO.: (If applicable,enter" e t-in.th licens�tumber ne.) Bus.Tel.No:,.�'V_ 77-9-2/c`�' Address: , '/ Pe`ul c r 1- -e ,k, i� c'ZC-(keL b 114 0 2 S-.j 2 Alt.TeL No.i q:3 - L Ce r-/e/77 Per M.G.L.c. 147,s.57-61,securitywo requires Department of Public Safety"S"License: Lic.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 agent. Owner/Agent Signature Telephone No. PERMIT FEE:$