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Home My WebLink AboutBLDE-23-003253 Commonwealth of Official Use Only IL ,,IN Massachusetts Permit No. BLDE-23-003253 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:12/12/2022 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) 9 PHYLLIS DR Owner or Tenant SERRA ELEANOR L Telephone No. Owner's Address 2813 CABARET ST, PT CHARLOTTE, FL 33948-1502 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 j Number of Feeders and Ampacity c Location and Nature of Proposed Electrical Work: Kitchen renovation Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 8 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA, No.of Luminaire Outlets No.of Hot Tubs Generators `.jCY.1t` No.of Luminaires Swimming Pool Above 0 In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 16 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 1 No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 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: MICHAEL TOTTEN Licensee: MICHAEL TOTTEN Signature LIC.NO.: 22421 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:228 STONEY CLIFF RD, CENTERVILLE MA 02632 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 ` � 4 ti 12(t4(7 L. OW' 'gp S i ram) 4 wtcfi I I n ✓ivlafi i RECEI E D `, Cnnunanwaa(th_` �A, � Official Use Only DEC l5 /`� Permit No. 23—3 2 3 1 �. .pali/11I1.i Of}%M&eeuc.d "1/4: Occupaacy and Fee Checked BUILDING / EN7B BARD OF FIRE PREVENTION REGULATIONS [Rev.l/07) (leave blank) l3➢.--__ -- ------ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code EC,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (Z i Z 2.)22 City or Town of: 0-�-o/(11L4{t\ To the Ins ecto of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) cl ytcv`r',S .hCs d e Owner or Tenant e`er Y\ 0(2_ l_ 5e t-r-os. Telephone No. Owner's Address Is this permit in conjunction with a buildingrmit?j permit?, Yes No ❑ (Check Appropriate Box) Purpose of Building I'(, cL 2t^ (Ze r't Ddv\ Utility AuthorizationNo. Existing Service k00 Amps (2C /21LD Volts Overhead u Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: 'Irv, cN (1 G)1 r,het 4 t' I,�r-t-ci e� rfi`n O uc..c-1 a v�o I VI Completion of the following table maybe waived by the Injector of Wires. No.of Recessed Luminaires s, No.of Cell Sn T ap.(Paddle)Fans T .of Total nasformers KVA t No.of Luminaire Outlets No.of Hot Tubs Generators KVA a No.of Luminaires Swimming Pool Above In- 1-7 No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets l 6 No.of Oil Burners FIRE ALARMS No.of Zones 7 No.of Switches 2Burners No.of Gas No.of Detection and Z. Initiating Devices IL) No.of Ranges ( No.of Air Cond. Tons No.of Alerting Devices Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers l .-........................_. O Totals: v c-_]Detection/Alerths Devices No.of Dishwashers ( Space/Area Heating KW LowMConneMionunicipal 0 other No.of Dryers Heating Appliances KW Security Systems:* ( No.of Devices or Equivalent 2. L. No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent nI No.Hydromassage Bathtubs No.of Motors Total HP 'Feiecommunlcations Wiring: V No.of Devices or Equivalent v OTHER: Q Ai Attach additional derail if desired,or as required by the Inspector of Wires. N Estimated Value o El trical Work: C'SOD " (When required by municipal policy.) `n Work to Start: i Z-2_ Inspections to berequested in accordance with MEC Rule 10,and M°I upon completion. INSURANCE C VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless providesproof of liability ° the licensee insurance including"completed operation"coverage or its substantial equivalent. The 6, undersigned certifies that such coy er 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 theo?ins and penalties ofperjary,that the Information on this application is true and complete. 601 FIRM NAME: I l i ko.Q .9i,..c ._A-cr C Li,C LIC.NO.: ZLt{Z( A [�O I Licensee: IN-1; CIna-9--k '0 1 Signatures LIC.NO.: l Lib Lig E' (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: 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. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 7,5= 0 --f ( 03