The URL can be used to link to this page

Home My WebLink AboutBLDE-22-006920 Commonwealth of Offi920cial Use Only Massachusetts Permit No. BLDE-22-006 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:5/31/2022 City or Town of: YARMOUTH To the Inspec for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 18 AUTUMN DR Owner or Tenant SCOTT BRUCE Telephone No. Owner's Address CIO REID ROBERT H, 18 AUTUMN DR, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 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: Renovation/Remodel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 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 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 ❑ 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 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 46124 wQ -o bi) i P aivs 4 ‘1,7-04\(---- NO' Ott/VOL 75OD RE_C_EIVED MAY 312022 yy]]/� •nwaahh.of ttladeackaatie Official Use Only ` y-� rING DEflARTME I n Permit No, GZZ- �6I ZC � ai,_J _ aj}aremenl .7w Jaroicae g 1`.. I."_!'`— Occupancy and Fee Checked \/f 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: e City or Town of: YARMOUTH To the Inspector of Wires: n^ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. `V 1 Location(Street&Number) fly a ;rhAv - 1:7 Owner or Tenant A W n-e.c Telephone No. S44 Owner's Address I k aV.�&q-vt-- D rL / 5t' Is this permit In conjunction with a building permit? Yes ❑ ^No �y (Check Appropriate Box) -` Purpose of Building r'P Utility Authorization No. 'C. - Existing Service %„J Amps / Volts Overhead Er Undgrd❑ No.of Meters i �. New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i .3,;t,01.iT p 0,4 t 0 r\ //2 yne d is Completion of thefollowingtable my be waived by the Inspector of Wires. Total Ue No.of Recessed Laminaires No.of Cell.s Transformers KVA asp.(Paddle)Fans r.of n,/ VA CiNo.of Luminaire Outlets No.of Hot Tubs Generators KVA d- No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grad. Rrnd. Battery Units �t No.of Receptacle Outlets No.of 011 Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and c' _ Initiating Devices t l,r No.of Ranges No.oe Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons_ KW No.of Self-Contained Totals: _... .. ..��- ��-� Detention/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑Monneunicipalction ❑other No.of Dryers Heating Appliances KW No Security Systems:* Devices or Equivalent No.of Water KW Ro.of No.of Data Wiring: Heaters Sins Ballasts g No.of Devices or Equivalent No.Ftydromassage 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: 2't'tgr) (When required by municipal policy.) Work to Start: 5 3/ lnspec ions to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by Inc 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: 0 O r).p -- .e PG 161a &i0' LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.TeL No: Address: AIL Tel.No.: 'Ter 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. 1 am the(check one)❑owner ❑owner's agent. Owner/Agent t'S Signature �S., �'—jJ%u-,/ Telephone o. 3 *3251 PERMIT FEE:$