HomeMy WebLinkAboutBLDE-23-000520 Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-23-000520
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 PR/NT IN INK OR TYPE ALL INFORMATION) Date:8/2/2022
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 electrical work described below.
Location(Street&Number) 11 AUNT EDITHS RD
Owner or Tenant HATHAWAY STEPHEN CHARLES Telephone No.
Owner's Address HATHAWAY LESLIE ZEOLI, 178 LEXINGTON DR, ITHACA, NY 14850-1719
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 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Out building for sauna.
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 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: RICHARD W CRAWFOR D
Licensee: Richard W Crawford Signature LIC.NO.: 13923
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:84 CRANBERRY LN, S YARMOUTH MA 026641005 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
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0 E ='== ' Occupancy and Fee Checked
i— BOARD OF FIRE PREVENTION REGULATIONS p ]y (leave blank)
Rev. 1/07
N ' PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
W 1 O J I All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
CD IL( L ASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 01 AUGUST 2022
W d I City or Town of: YARMOUTH To the Inspector of Wires:
1 lEi t i s application the undersigned gives notice of his or her intention to perform the electrical work described below.
LL
LP,h 'on(Street&Number) 11 AUNT EDITH'S ROAD
Owner or Tenant STEVE HATHAWAT Telephone No. 603-339-7698
Owner's Address
Is this permit in conjunction with a building permit? Yes ® No n (Check Appropriate Box)
Purpose of Building OUT BUILDING, SANUA Utility Authorization No.
Existing Service 200 Amps / Volts Overhead ❑ Undgrd n No.of Meters
New Service Amps / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: INSTALL SUB PANEL, WIRE SHED FOR LIGHTING
AND SAUNA UNIT (60A SUB PANEL VIA UNDERGROUND)
Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
of
No.of Switches No.of Gas Burners No. Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
P Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other
P Connection
No.of Dryers Heating AppliancessAu N in,Kw6 Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of
E Data Wiring:
0 Heaters KW Signs Ballasts No.of Devices or Equivalent
0 Telecommunications Wiring:
No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
cn
E OTHER:
aAttach additional detail if desired,or as required by the Inspector of Wires.
12
O 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.
2 INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
v the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
asundersigned 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 this91{plication is tr a and complete.
FIRM NAME: Crawford Electric 1 LIC.NO.:13923A
Licensee: Richard Crawford Signature yiZeir/.c.,- ,--s--/J LIC.NO.:23888
(If applicable,enter"exem t"in the license number line.) ✓--- Bus.Tel.No.: 508-737-0194
Address: 84 Cranberry Lane, South Yarmouth MA. 02664 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)❑owner ❑owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.