The URL can be used to link to this page

Home My WebLink AboutBLDE-23-000245 - 0 ,,,,\ (4\�� Commonwealth of Official Use Only ifi-Alli Massachusetts Permit No. BLDE-23-000245 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:7/14/2022 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 b low. Location(Street&Number) 2 BOULDER CIR 7te' —I'C)?- 66 7 Owner or Tenant CROWLEY KEVIN BARRY Telephone No. Owner's Address CROWLEY MARY ANN, 7 FAIRWAY LN, PEMBROKE, MA 02359 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: Wiring for 1/2 bathroom. 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 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton l No.of Alerting Devices 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 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 (1.2, t,. ,,?eh>I t /7,7. ,Fx.w. (0.iw RECEIVED JUL 14 2022 q. 'nwaa h of y aaac has.lfe Official Use Only i.- . NG DkPARTM -- n _x-- / Permit No. Z3 v 24M"' - 2-epartmant aiJhr&mace,'I I a Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev.1/07] (ieavewank) 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: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersignegives notice of his or her intention to perform the electrical work described below. Location(Street&Number) a. G o,r.\c),.T cFN•. -c\'P Owner or Tenant c wv--e-a- Telephone No.7St-(a0 S`((Dell 1 Owner's Address O.-,--.• 0., C�\es a'U Is this permit in conjunction with a building permit? Yes No ❑ (Cheek Appropriate Box) Purpose of Building . Utility Authorization No. Existing Service V/ Amps /s2 O/;YOVolts Overhead❑ Undgrd d No.of Meters t New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty \\Location and Nature of Proposed Electrical Work: l..t.r c c>_v.. ,iv.e....) Y . '( w `` .. . s r Q`w Cv S s \....c•,•,N,-.. • Completion of the following may be waived by the Inspector of Wires. tin No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.or Total to ,Transformers KVA A No.of Luminaire Outlets No.of Hot Tubs Generators KVA tF No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting ayrnd. ❑ grnd. ❑ Battery Units ^i No,of Receptacle Outlets 's No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 11' No.of Ranges No.aAir Cond. To No.of Alerting Devices No.of Waste DisposersHeat Pump Number Tons KW No.of Self-Contained Totals: . _.._.__..__.......__._.._.._...._..._........ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Munlcipannection other ❑O Co No.of Dryers Heating Appliances KW SecNa of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heater Signs Ballasts 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 al Work: (When required by municipal policy.) Work to Start:t')' 0 a?. Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VE 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND 0 OTHER❑(Specify:) I certify,under the pains and penalties of peiury,that de information on this applicati is true nd complete. FIRM NAME: ',Rai``''- Ls O W ¢.y1 LIC.NO.: Licensee: Signature . �G'e IC.NO.: (If applicable.enter"exempt"in the license number line.) .Tel.No.• 7`,,I- L O 3 Address: L TeL No.: (a tt S47 *Per M.G.L.c.147,s.57-6I,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. B my signature I hereby give this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent t y� Signature •J t elephone No. 7 S 1^ Fe O 3(PERMIT FEE:$ Co 0 S^j