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Home My WebLink AboutBLDE-23-005696 or Commonwealth of Official Use Only ��,,� Massachusetts Permit No. BLDE-23-005696 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•4/13/2023 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) 24 HEDGE ROW Owner or Tenant MARTIN RILEY Telephone No. Owner's Address 24 HEDGE ROW, WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Approptiate Boa) ,' Purpose of Building Utility Authorization No. d Existing Service Amps Volts Overhead 0 Undgrd ❑ No of/,eters `' New Service Amps Volts Overhead 0 Undgrd 0 I 'o.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel kitchen c . s Completion of the following table may be waived byYhe Inspector of Wires. No.of Recessed Luminaires 16 No.of Ceil.-Susp.(Paddle)Fans No.of `.Total ' Transformers IikA 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 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. 1 Total 2.5 No.of Alerting Devices Tons 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 Euuivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Euuivalent 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 ❑ BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Stephen M Childs Licensee: Stephen M Childs Signature LIC.NO.: 32325 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 145 CAMMETT RD, MARSTONS MLS MA 026481519 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 !ti Uete Y(/g t/n of z,vvlct i l 1,vtv r - RE,CEIVED '�—�` 2023 ommonwealth of Massachusetts Permit No.: [ AP 7,ad� Department of Fire Services Occupancy and Fee Checked: By ILA-:,_ it ISVAliI) OF FIRE PREVENTION REGULATIONS [Rev.1/2023] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12 0 City or Town of: YARMOUTH Date: ��/1 oC. 3 To the Inspector of Wires:By this jtpplication,the undersigned gives notices of his or her intention to perform the electrical wodc described below. Location(Street&Number): cl #e,;(re i€U Unit No.: Owner or Tenant: /q',e7;/7 X.',/Cr Email: Owner's Address: e(//7' ( hone No.: Is this permit in conjunctjon with building permit?(Check appropriate box)Yes No❑Permit No.: Purpose of Building: i `1 G/L(J t'lli"y Utility Authorization No.: Existing Service:, '0 Ampg'e//I/2&Volts Overhead❑ Underground 2 No.of Meters: I New Service: Amps / Volts Overhead❑ Underground 0-&X S /I/'No.of Meters: Description of Proposed Electrical Installation: �� 7.L �, )7, /C4 k 4 747 flew .4"c -7?76 '/4y �q/� /YGC.. .. a Completion of the following table may be waived by the Inspector of Wires. No.of Receptable Outlets: No.of Switches: /2, Generator KW Rating: Type:. No.Luminaires: No.of Recessed Luminaires://6 No.Wind Generators: Wind KW Rating: No.Appliances: KW: No.Water Heaters: KW: No.Transformers: Total KVA: Space Heating KW: Heating Equipment KW: No.Motors: Total HP: Total KW: No.Heat Pumps: Total KW: Total Tons: Fire Alarm System❑ No.of Devices: Swimming Pool:In-Gmd.❑ Above-Gmd.El Hot-Tub❑ No.of Self-Contained Detection/Alerting Devices: No.Oil Burners: No.Gas Burners: Video System ❑ No.of Devices: No.Air Conditioners: / Total Tons: aA Telecom System 0 No.of Outlets: No.Energy Storage Systems: KWH Storag ting: Security System ❑ No.of Devices: Solar PV KW DC Rating: Solar PV KW AC Rating: No.of Electric Vehicle Supply Equipment: No.of Modules: Roof-Mount 0 Ground-Mount❑ Level I❑ Level 2❑ Level 3 0 Rating: OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: S G o c' (When required by municipal policy) Date Work to Start:Gill/:Z(o2,' Inspections to be requested in accordance with MEC Rule 10,and upon completion. FIRM NAME: S -y?c 2 C/ems) A-1❑or Crl. LIC.No.: Master/Systems Licensee: LIC.No.:Journeyman Licensee: Ay 4e/f(/7/G,bs LIC.No.:t 3.1-4 ..R.S_ Security System Business requires a Division of Occupational Licensure"S"LIC. S-LIC.No.: Address: /e/ l Cc-,"29/77 c ('tc / Email: 7�ue '4/L O s- 3 2,-Ce t'X/, S A . Ce/72 Telephone No.: _5-45 c'a —Jd lg I certify,under the pains and penalties of perjury,that the information on this application is true and complete. Licensee: ,�4�-7 C Print Name: .7 ,OI,'a ('/ i,/( Cell.No.: 52:1X-e7G`f6/k INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability including"completed operation"coverage or its substantial equivalent.The undersigned certifies that such coverage is in force and has exhibited proof of a to the permit issuing office. CHECK ONE: INSURANCEUBOND❑ OTHER❑ Specify: 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)Owner❑ Owner's agent 0 Owner/Agent: Tel.No.: Signature: Email.: