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Home My WebLink AboutBLDE-22-003869 Commonwealth of Official Use Only ster""- v iE` �' /\ Massachusetts Permit No. BLDE-22-003869 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:1/11/2022 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 elec(,ti l work� elOw. Location(Street&Number) 243 WEST GREAT WESTERN I Owner or Tenant T P Telephone No. Owner's Address 243 WEST GREAT WESTERN RD, YARMOUTH PORT, MA 0 .75/ 40 - Is this permit in conjunction with a building permit? Yes 0 No 0 (Che ti�, 1 pt., Purpose of Building Utility Authorization No. o Existing Service Amps Volts Overhead 0 Undgrd 0 thNew Service Amps Volts Overhead ❑ Undgrd ❑ No. , A Number of Feeders and Ampacity 4I, Location and Nature of Proposed Electrical Work: Rewire unit&replace panel. v d Completion of the following table matk aived ctor of Wires. 4 No.of Recessed Luminaires 18 No.of Ceil.-Susp.(Paddle)Fans No.of /� al Transformers /z3 A No.of Luminaire Outlets 4 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 26 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 19 No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. 1 Total 2 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 1 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: David M Hawkins Licensee: David M Hawkins Signature LIC.NO.: 31112 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 14 UNCLE JIMMYS LN, YARMOUTH PORT MA 026752252 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: $125.00 RECEIVED L. ``�, LAN 112022 \i 14 CommoruoeaUh o j Maeeae Official Use Only "`^¢ c� li BUILDING DEPART ilsa ' --30e;P> �'i f 2eparimeni 01 glee ].lei.-az— 1 i Occupancy and Fee Checked c BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank)v 4, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK C:: All work to be performed in aceatdance with the Massachusetts Electrical Code(MEC), 27 CMR 12.00 a (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / /9 City or Town of: yhw Ynojr1-1- To the Inspector of Wires: .1 By this application the undersigned gives notice of his_or her intention to perform the electrical work described below. Location(Street&Number) ;�93 (,C 5 / 4-nb9-7-be&5T6R.IV 1 Owner or Tenant - Telephone No. • Owner's Address iLI WC tP,dt' 1'24) .S�,,1) lERtj1//CK /, Is this permit in conjunction with a building permit? Yes d No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. n Existing Servlceaco Amps j�C/�tlb Volts Overhead RI Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑'/ N of Meters Number of Feeders and Ampacity a f{f..,s !' i/< /ex.,fI 1=/tG id Du pLe Location and Nature of Proposed Electrical Work: ,�>v P ,2c PLicrc ; ' JP Completion of the follorcin•table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 No.of Ceil.Susp.(Paddle)Fans Na.o Total TrTransformersKVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KV A No.of Luminaires /J swimmingPool Above ❑ In- ❑ No.of emergency Limiting-/ grnd. grnd. Battery Units No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches I el No.of Gas Burners No.of Detection and 1 Initiating Devices No.of Ranges j Erns No.of Air Cond. I Ton s a No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons _KW No.of Self-Contained Totals: -- Detection/AlertinkDevices No.of Dishwashers ) Space/Area Heating KW Local 0 Municipalnnection 0"her C No.of Dryers t Heating Appliances KW No o Systems:* 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 Telecommun bluing: No.of Device sons es or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of Wires. Estimated Valueq/f,El trical Work: / (When required by municipal policy.) Work to Start: j I t j 1?.,:„1 Inspe6tions 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 liabilityinsurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 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: ii, LIC.NO.: Licensee: "6 hi<tt4/"..jiv( SignamreA Xjj, n, LIC.NO.:/.73/l/c2 (If applicable,enter"exempt"in the license Y{number line.) Bus.Tel No.' 9'7 y l.2 .'06 A Address: /11 u/t/C-IC" "Ti ill t9 t L_71,) y/92 f,)cuM Q-,i1—r 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 0 owner's agent Owner/AgentPERMIT FEE:$ SignaturetuneTelephone No. - 1 • '. r • • • •