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Home My WebLink AboutBLDE-22-002471 or Commonwealth of Official Use Only ,t. Massachusetts Permit No. BLDE-22-002471 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:10/30/2021 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) 25 WEST WOODS VILLAGE Owner or Tenant SUMMERFIELD MARTIN A Telephone No. ®• Owner's Address 441 ROUTE 6A,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 ( rop4 ) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o. f e New Service Amps Volts Overhead 0 Undgrd ❑ r /�i ' Number of Feeders and Ampacity446 `-V Location and Nature of Proposed Electrical Work: Basement remodel (Bath, hall, closet, &family room) �}[ Cotnpletion of the following table c� w ivT �� e Spector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of e , 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 16 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 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 KW ,No.of Self-Contained Totals: Detection/Alerting 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 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: William L Wolaszek Licensee: William L Wolaszek Signature LIC.NO.: 28768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:96 CAPTAIN LOTHROP RD, S YARMOUTH MA 026642818 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: $75.00 V--cbuc,t,t (t(3(-21 (c RECEIVED A, yy� OCT2 9 2021Co aa[th of rrtoeeachueeite FFOfficial Usese Only !I �''/ Permit No. C��''—"t1( .! �.DING DEPARTM_ !P' nto`Jur.-ievicea // Occupancy and Fee Checked • -■ • 'REVENTION REGULATIONS [Rev.I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 Cy R 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /p ,,7 9/ a City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ;,$ Wp,S4 Uit5e/a s 1(, C L...1 C Owner or Tenant ,/f1( U ys.,v.-wkc( l''e 18. `Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes IN No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty Location JJand Nature of Proposed Electrical Work: . v'( -N ?E( 3 c,�e )i„ v 4i J JAI I- oar 7'h )(1 Clos-9 Fc is .)J OYL. v® Cothpletion of the followingtable may be waived by the Inspector of Wires. tb No.of Recessed Luminaires No.of Cell.-Soap.(Paddle)Fans No.of 7 otal Transformers KVA `` No.of Luminaire Outlets No.of Hot Tubs Generators KVA Y No.of Luminaires // Swlmming pool Above in- No.of Emergency Lighting grod. ❑ grnd. ❑ Battery Units ',,,! No.of Receptacle Outlets /(o No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesBurners 0 No.of Gas No.of Detection and ~ Initiating Devices 1' No.of Ranges No.of Air Cond. Tons! No.of Alerting Devices No.o(WasteINaposera Heat Pump Number Tons_._ KW No.of Self-Contained Totals: -_.. _......._._..."`.... Detection/Alerting)evices No.of Dishwashers Space/Area Heating KW Local❑Monnectiounicipaln ❑one. No.of Dryers Heating Appliances KW Sec uri No o Cf Devices or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Ballasts 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 lec cal Work: p�FR6 c (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule I0,and upon completion. INSURANC CO E: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 0 OTHER 0 (Specify:) I certify,under the1 W pains� c. and penalties of perjury,that the information on this application is true and complete. FIRM NAME: it); 1Nw �`I Dic57p k LIC.NO.:a$762 t Licensee: . . (tJ(7k. 7.e Signature LiC.NO.: p' (If applicable,enter"exempt"in the license umber linen Bus.Tel.No.. O� S 0 6 ct S 1 Address: 9 C, CcQ't,y1 Lod-Lt=.�/( 1{a Q4`t un c>• n. Alt.Tel.No.:5 tv Per M.G.L.c.147,s.577-61,security work rdyuires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: i am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$