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Home My WebLink AboutBLDE-23-004447 i ( t Commonwealth of Official Use Only I ,14) b Massachusetts Permit No. BLDE-23-004447 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/071 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 elecmcal work described below. Location(Street&Number) 10 MIDSTREAM DR Owner or Tenant WELBURN KAROL A Telephone No. Owner's Address 10 MIDSTREAM DR,SOUTH YARMOUTH,MA 02664 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Porch to 3 season room. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 No.of Ceii:Susp.(Paddle)Fans 1 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 9 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 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 KVV Neot eocf iSenlArnttinainn Dde vicesTotals: No.of Dishwashers Space/Area Heating KW Local ❑ 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 IIP 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 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: Licensee: Signature LIC.NO.: (Ifapplicable.enter"esempt"in the license number line.) Bus.Tel.No.: Address: 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 ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 S k 3(q( r/ /46 yfl eom 16 OJbY Lim perin,• 4- RECEIVED .. `, Vjaddachadalfe Official Use Only Is^_ L..-ea ,, FEB 10 206'0,4,d:the/ �%23 L =C :r_ , c� c7PermitNo. U7- _ .LJJi oasmsnt o` }ire Serviced-: 7I W I N G DEPARTMENT 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: ��Z�,�.? 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) '! /�jIS ii1i l�t, Owner or Tenant �.i rei OA,A d rr Telephone No. �3 -�,�d/ �33� Owner's Address IC A l sly too ]),-i fit. So ii{k Ya(070 ur H- Is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box)BO ^22 -or,c<a5 Purpose of Building 3 Sea s(IA_ po/ 4- Utility Authorization No. Existing Service /0 0 Amps / O/a1-4OVolts Overhead LrJ 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: pa fc l 4c, 3 — �cl. 1d 0 �i�tLN a, /t1cf/di 1 P Vr} Completion o re followinilable may be waived by the Inssector of Wires. otal lif No.of Recessed Luminaires No.of Ceil.-Snap.(Paddle)Fans Nr.as Tformers KVA el _ Trans C. No.of Luminaire Outlets No.of Hot Tubs Generators KVA — . No.of Luminaires • SwimmingAbove In- No.of Emergency Lighting Pool grnd. ❑ grad. ❑ Battery Units �' No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS No.of Zones 4. No.of Switches 9 No.of Gas Burners iNo.of Detection and v. Initiating Devices Tota1 1•! No.of Ranges No.4Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons I'""'W No.of Self-Contained Totals:I -" KDetection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KWSecurity Systems:* No.of Devices or Equivalent No.of Water , No.of No.of Data Wiring: - Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP a Coecoe 1 munications 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 the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: t Signature LIC.NO.: /�/ ,9 h (If applicable,enter"ezemp "in the license umber line. Address: us.Tel.No. / i m - `ITT Alt.Tel.No.:Sew' 31.,7 Fg63 - *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 insu JR,ucc coverage normally required by law. By my signature� below,I hereby waive this requirement. I am the(check one) owner 0 owner's agent. Owner/Agent AI 0/,t'/ I Signature � — Telephone No. 4/ 3 fez y ( PERMIT FEE:$ ”35