The URL can be used to link to this page

Home My WebLink AboutBLDE-22-001361 tik 0 Commonwealth of Official Use Only =':+try% Permit No. BLDE-22-001361 t Massachusetts 4...„,, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/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:9/9/2021 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) 20 BUCKWOOD DR Owner or Tenant Tim Kelly Telephone No. Owner's Address 20 BUCKWOOD DR, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o �/�' e New Service Amps Volts Overhead 0 Undgrd 0 , 1 Mt* _ Number of Feeders and Ampacity /4r111.8r. r oP Location and Nature of Proposed Electrical Work: Remodel kitchen, mud room,&dining room. O , 3 Completion of the following table fltA • ed by t . ' of Wires. No.of Recessed Luminaires No.of Ceil: No.of ', Susp.(Paddle)Fans Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grad. 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 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 Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens 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 0 (Specify:) �„e- �qt-0 5-65 I certify,under the pains and penalties of perjury,that the information on this application is true and complete.�J FIRM NAME: Licensee: John Weiss Signature LIC.NO.: 22602 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:63 Uncle Bobs Wy,South Dennis Ma 02660 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 Qat/ 1/1 if/V geai'r re/. 'ed711 /\4S>1 • RECEIVED L.omm:m.4bl o`Km.-Loth Official se fly `- -1-' -'13 61 SEP 0 S 2041 ,to2ccA ��'''// Pemdt No. eparemant�Jire Serviced Occupancy and Fee CdLDING DEHAR"WENT U • BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave bl BY v APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed m accordance with the Massachusetts Electrical Code( C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAEON) Date:Co; City or Town of: c�kwr.lrZ1 To the Ins ect r of Wires: .1 By this application the undersigned gives notice of his or her intentjpa to perform the electrical work described below. Location(Street&Number) Q, c4C/La...t_oPf Owner or Tenant rl,-.4 el y� -/ Telephone No. 4. ✓ Owner's Address Zd nGC/[C AGO f� • Is this permit in conjunction with � Remit? Yes ® No ❑ (Check Appropriate Box) ti Purpose of Building e 6 /Td ceA Utility Authorization No. 6. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters to New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity `" �'� (' Location andll Nature of Proposed-> Electrical Work: /2eI'wTq e t fe,^7 c4(,°!^ 4 .. VI'i(t,Ol'tetvl, j)rin,/,y I fro01 c hr� Completion of thefollowio table may be ived by&Inspector of Wires. UI No.of Recessed Luminaires No.of Cef.-S.ip.(Paddle)Fans No.of Total St Transformers KVA t No.of Luminaire Outlets No.of Hot Tuba Generators KVA Above In- No.of Emergency Lighting k No.of Luminaires Swimming Pool grand. ❑ grad. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones and F No.of Switches No.of Gas Burners 'No.of DetectionDevices Devices I VI No.of Ranges No.of Air Cond. Taos No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P° Totals: —.._._..---...�._........._......... Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW Local❑Mona h'on ❑other No.of Dryers Heating Appliances KW Security Systems:* ray No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivallent municatins Wiring: No.Hydromassage Bathtubs No.of Motors Total HP Tel co No of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value ofcal Work: (When required by municipal policy.) Work to Start: S> 2/ inspecti s to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE RAGE: 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 tha.Ral and penoblls ofperjtrry,that the bnf.'rmadon on this application is true and complete. FIRM NAME: J d'7 Ct.ess LIC.NO.:22 4 Licensee:Jokes(,,/e,'5 Signature — LIC.NO.: of applicable. "e ens 'rap t / fine./ Bus.TeL No.•S��y/05'P1 Address: ) 7 i t,"/ /`'/ S'l,�e/t 's Alt.Tel.No.: 'Per M.G.L.c.147,s.57-61,security work 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)0 owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No.