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Home My WebLink AboutBLDE-23-004051 Commonwealth of Official Use Only c_- Ems; Massachusetts Permit No. BLDE-23-004051 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:1/23/2023 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) 21 LYMAN LN Owner or Tenant MARIE SERNO Telephone No. Owner's Address 21 LYMAN LN, SOUTH YARMOUTH, MA 02664-4122 / Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) , "f Purpose of Building Utility Authorization No. ,` t 1'` Existing Service Amps Volts Overhead ❑ Undgrd CI 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: Replace devices,fixtures,&add recessed lights. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 16 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- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 24 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 25 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 5 Totals: Detection/Alertine Devices _ No.of Dishwashers 1 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 Siens 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: BRYANT K DUNDON Licensee: Bryant K Dundon Signature LIC.NO.: 53109 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:67 TAURUS DR, MASHPEE MA 026493458 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: $50.00 l <rl� /�/cc .i3r/REFC � �IFD ' UCll / ei % jnJu/ ce. - - JAN 1� d, �� 23�OLo ea!!h of tt/aeaac�iuea!•le �O�ffficial,U(see Only °4k{tf�,-..:0 DING DEPA RTf,4 c7 n Permit No.`-"�� 1 oc( e.[!>..: _— -__- "```.''"'-'''"��PPPPP of of)ire-Cervices I I"J Occupancy and Fee Checked BOARD OF FIR 'REVENTION REGULATIONS [Rev.1/07] (leave blank) -.i 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: J c Zjt �o ZCity ur Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or he/r intention to perform the electrical work described below. Location(Street&Nu^m'�bbeer) Z L �/n� (��z_ Owner or Tenant /// /„� �) Telephone No.7.1�jc/'.97. Owner's Address Is this permit in conJuncti with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building pc„4Gi/i/t UtilityAuthorization No. Existing Service /c. 1 Amps ix,-/.ro Volts Overhead Undgrd❑ No.of Meters I New Service Amps / Volts Overhead❑J Undgrd r g ❑ No.of Meters J Number of Feeders and Ampadty �aton and Nature of Proposed Electrical Work: . e_ ��7 J �X "� .4�-v Kr1 q ///�� /�� 1 Af P5h /i��5 t />1�LL //n/rr f G// /./G-�L7 �' •to Completion of the followinvable may be waived by the In ector of Wires. No.of Recessed LuminairesSn �� No.of Cell: ap.(Peddle)Fans No.of Total oi Transformer KVA nNo.of Luminaire Outlets No.of Hot Tubs Generators KVA d No.of Luminaires .5 Swimming pool¢rnd.Above 0 gr In-nd. Ba 0 Nott.ofery Emerg Unitsency Lighting Zzl No.of Receptacle Outlets Z r,/ No.of Oil Burners FIRE ALARMS No.of Zones Na.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices J i a No.of Ranges / No.o'Air Cond. Tons No.of Alerting Devices No.of Waste DisposersRest Pump Number Tons.,.,._ K_W No.of Self-Contained Touts: " Detection/Alertin Devices No.of Dishwashers / Space/Area Heating KW Local 0 Municinnectipalon 0 Other Co No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wirin Heaters 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 Electrical Work: 33oC, (When required by municipal policy.) Work to Stan: / 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 BOND 0 OTHER 0 (Specify:) I certify,under the poly and p allies gy(perju/ry,that the�ormation on this application is true and complete. FIRM NAME:77 ,,,r /,//ln61c� .�rc></GY/ LIC.NO.:5�o 3 Licensee: `��yi-- Signature LIC.NO.:,S3/er (If applicable,one exempt"in the license number line.) Bus.Tel.No: 7'77, 99 G, 1 Address: Alt.TeL No.: C 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)D owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE:$