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Home My WebLink AboutBLDE-23-003789 of `. \ Commonwealth of Official Use Only fE., 4A Massachusetts Permit No. BLDE-23-003789 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/N INK OR TYPE ALL INFORMATION) Date:1/12/2023 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) 9 PEQUOD CIR Owner or Tenant WORRALL ANDREA J Telephone No. Owner's Address 9 PEQUOD CIR,YARMOUTH PORT, MA 02675 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 Meterse i Number of Feeders and Ampacity 7 Location and Nature of Proposed Electrical Work: Bathroom remodel Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 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 4 No.of Gas Burners No.of Detection and Initiatine 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/Alertine 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 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: Michael Donovan Licensee: Michael Donovan Signature LIC.NO.: 15197 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 OLD MAIN ST, WEST DENNIS MA 026702224 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 t2C)year-- (OH(2%3 Commonwealth o/Maeeachueatte Official Use Only t � c� �7 Permit No. 11/4 ;�' 3spartmsnt ol.}iro —)srvicse 11:�' Occupancy1/07] and Fee Checked thjoBOARD OF FIRE PREVENTION REGULATIONS Rev. leave blank APPLICATION FOR PERMIT TO PE RFORM 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: YA R M O U T H 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) ci 'Pe q U Or) , , Owner or Tenant A ,,,, c) fee U (.4 ) Telephone No. Owner's Address ��l Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building A�„ c, �� Utility Authorization No. v Existing Service t b t' Amps 1.f) /2. `t<G Volts Overhead ❑ Undgrd U No. of Meters ` New Service Amps :-) Volts Overhead E Undgrd n No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ` . .,r Gig g t �V v Q us, Q. a, `VI Completion of the followingtable may be waived by the Inspector of Wires. 'il. No. of Recessed Luminaires ' No. of Ceil:Susp.(Paddle) Fans No. of 7 otal ev Transformers KVA CA n No. of Luminaire Outlets No. of Hot Tubs Generators KVA ,-1" No. of Luminaires ` Swimming Pool Above ❑ In- ❑ No. of Emergency Lighting y urnd. grnd. Battery Units �" No. of Receptacle Outlets 1 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No.of Gas Burnerso. of Detection and ti ` ` _ Initiating Devices 'I. ,' No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons 1(W ,NO. of Self-Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal ❑ Connection ❑ Other No. of Dryers Heating Appliances KWSecurity Systems: No. of Water No. of Devices or Equivalent KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Dvices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs INo. of Motors Total HP g No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3 OW. ce, (When required by municipal policy.) Work to Start: ` ' 3 2 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 El OTHER 0 (Specify:) I certify, under the pains and penalties of perjury, that the inf rmatlon on this application is true and complete. �1 FIRM NAME: }pl t 41.5 'J4 e i) t9 e1 e A ,Tc4- t�?cri S do (Ors LIC. NO.: l S1 q 2 4 Licensee: fro,C ,r a p , c e n pn Q j e^ Signature LIC. NO.: (If applicable, enter "exempt"in the li a n,�urben e. Bus. Tel. No.: .S"4'g-72C Ojj"•d 9 Address: 7/ Qlc� 04.t, I�IJtof 41,_/3 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, 1 hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ I