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Home My WebLink AboutBLDE-22-003235 _. Commonwealth of Official Use Only fi , Massachusetts Permit No. BLDE-22-003235 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/N INK OR TYPE ALL INFORMATION) Date:12/7/2021 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) 71 NOTTINGHAM DR Owner or Tenant David Snowden Telephone Owner's Address 71 NOTTINGHAM DR,YARMOUTH PORT, MA 02675-0400 O Is this permit in conjunction with a building permit? Yes 0 No 0 40. 1,, c A; 'ate Box) Purpose of Building Utility Authorizatio [e'' Existing Service Amps Volts Overhead 0 Undgrd • „ ire New Service Amps Volts Overhead 0 Undgrd 0 1Q'o 'e Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In-ground pool 44P) 4 *? Completion of the.following/� y the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No,of O 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 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 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 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR, S YARMOUTH MA 026641339 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: $130.00 ik-ot)-14) &-tiPP-Anti c-bi,ay-r Q&A\ic (1-1 8)w r_ , ?An () c-. ra-cu t o(iu. jf t 4 f zK _ —ham t. tO C mmonwea!!h o`///aeeachwaftd Official Use Only Vr'r_Y� `� ��+ PermitNo`�ZZ-3�3 E �:- eparinunt of Serviced I- Occupancy and Fee Checked L i 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)),,52 CMR 12.00 • V (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /L'// J/�.2/ City or Town of: / tl \1 YARMOUTH To the Inspecto of Wires: rV By this application the undersigned gives notice of his.or her intention to perform the electrical work described below. Location(Street&Number) 7/ No 171inc. /yr '. A14/Pa777 P r •yi Owner or Tenant -DAV)e) Srn Dir....) Telephone No. Owner's Address ,S,•.'v`--t, Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. c ` Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters v New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity �i Location and Nature of Proposed Electrical Work: rdr a/ i v` Completion of the followingtable muy be waived by the Ins Inspector of lVires. JNo,o[Recessed Luminaires No.of Ce6:Sosp.(Paddle)Fans No.of Total Transformers KVA 't No.of Luminaire Outlets No.of Hot Tubs Generators KVA t No.of Luminaires Swimming Pool Above In- No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 'No.Initiating Devices 1 No.of Ranges No.of Air Cond. Tons No.of Alerting Devices RestNo.of Waste Deposers Rest Pump Number-'Tons KW No.of Self-Contained Totals: -. .._.._.. . .... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local O CoMunicinnecpalon Other Connection No.of Dryers Heating Appliances KW Security Systems:. 'No.of Water KW No.of No.of Data WiriDevices or Equivalent ng: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: ydo0 µ 4- 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:/Z 2 Z/ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C V GE: 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE DIE BOND ❑ OTHER❑(Specify:) I certlfy,under the painsai and pens ties of perfury,that the information on this application is true and complete. FIRM NAME: ,1cL Ck. �j,:, }t,,N ^LIC.NO.: fill,t Licensee: -��: IC y�� 'r r:�f/� Signature LIC.NO.:TD-,..c?/? (lfapplicable. nt r-" rapt'in the license number e.) Bus.Tel.No.•y7�' y/1 ASt��Address: /,r,1 oyq" X A D , �?c 4 CA.(� Per M.G.L.c.147,s.57-61,security work requireseparhnent of Pu Safety"S"License: Alt.Lie 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)a owner Ej owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$ fl‘ • • • a .. . . •. . ... • - • _ -••••-