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Home My WebLink AboutBLDE-22-005946 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-005946 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:4/18/2022 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 be � �� o Location(Street&Number) 9 FROST AVE Z ` (Q 03 Owner or Tenant Robert Wray Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Rewire basement area. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 28 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 30 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 12 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 4 Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers 1 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 1 Total HP .5 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: $80.00 R*XtI +0 Vi nkr� evMv. 4 G-rat 6a.. Dki de. ►moo to) `-f(f 9 z3 (‘ -‘2-"1") eQ7A- 0(4/z a. (10:tvi-4,& - ( 4- 5 c8 -* C • RECEIVED APR 08 2022 J EPA n a� •• G DEPARTMENt- nwea[th II Official Use Only a z `° nn EZ2946o V '.:at.„,.' ..� eparlmenl of gin,Jeroicm Permit No. I'i ��' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M C),527 sMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) City or Town of: YARM O UTH �✓ � z rJ Z Date: S/To the Ins ctor of mires: ^ By this application the undersigned giyes notice of his or her intention to perform the electrical work described below. (`c..? Location(Street&Number) q /tD,s'r fJ� i Owner or Tenant `A� �L7J ` � �Zb �/��/"` �� fr' Telephoned No.5pg'33Z?3D , Owner's Address l J2c? ( fh ; j,U 1 v cc-t77// j�/-r: 02(P 7 3 Is this permit in conjunction with a building permit? Yes No 3 Purpose of Building ❑ (Check Appropriate Box) .� Utility Authorization No. Existing Service l�Amps / ' Volta Overhead❑ Undgrd g ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampadty I Location and Nature of Proposed Electrical Work: V, vm Completion of the fol%owin5 toble may be waived by the Inspector of Wires. U No.of Recessed Luminaires Zed No.of Ceil.-Susp.(Paddle)Fans No.of I otal " No.of Luminaire OutletsTransformers KVA No.of Hot Tubs Generators KVA "t No.of Luminaires Swimming Pool Above In- No.or Emergency Lighting l grad. grnd. 0 BatteryUnits �' No.of Receptacle Outlets if3J No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches /Z No.of Gas Burners No.of Detection and No.of Ilan es Initiating Devices g No.of Air Cond. total No.of Alerting Devices Tons No.of Waste Disposers Rest Pump 1um ber„ITons 1KW No.of Self-Contained `f Totals:I- I Detection/Alerting Devices No.of Dishwashers J Space/Area Heating KW a 1 0 Munidpa - No.of Dryers / Heating Appliances KW Security Systems:* 0 Otbe No.of Water No.of No.of Devices or Equivalent Heaters ' Data Wiring: Na.of Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors / Total HP //� Teleeommuoications WIn ng: _ _ No.of Devices or Equivalent OTHER: S Sr 67,l rJZr (D a.)//e-C,� -— /jf75t;t.-tG� . Day wif_ �� i An' Gee�/ OF Attach required detail I le or asrequired by the Inspector of Wires. E tttneted 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. 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❑ OTHER 0(Specify:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"excerpt"in the license number line.) Bus.Tel.No.. Address: .No.: °Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: Alt LiTel No. OWNER'S INSURANCE WAIVER: i am aware that the Licensee does not have the liability insurance coverage normally required by law. Bymy signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Own tune nt<, ��.r Signature 1iF Telephone No.; 33l%D I PERMIT FEE:$ l -----0( a) yet-Aptti)f,n---6_ ó45E dim/ Aihi / 5 f-Lt �. a far Sc Gar CL- 0)/4- E$ 1 37' ,b io/its 1776 3,c77-467( A-A)z-c So e'/)t /.�`� o 570 CD OIL0 49b6(----r /4"-- 4.0n vgvc' 7 7 �Z .� T