HomeMy WebLinkAboutBLDE-24-1618 l R. F: C° 7. t o Commonwealth / tt Official Use Only
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3 ;/ c� Permit No. 1
OCT(` ; _` i1 i_ a .2 epartment o� ire Service
II
�+ ;I1 'v Occupancy and Fee Checked
. 4,' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank)
L_____
BUILDING >E` "`
E3y---- A-PPL1GATION 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: October 18, 2024
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) 11 Aunt Edith's Road, South Yarmouth
Owner or Tenant Steve & Leslie Hathaway Telephone No. 607-339-
Owner's Address 7698
Is this permit in conjunction with a building permit? Yes n No ix (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
Existing Service 200 Amps / Volts Overhead n Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd n No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: renovate master hathroom
Completion of the following table may be waived by the Inspector of Wires.
.ofTotal
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans T
Transformers KVA
No.of Luminaire Outlets 1 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 3 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
6 Initiating Devices
No.of Ranges No.of Air Cond. Tons Tons No.of Alerting Devices
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 ❑ Other
Connection
No.of Dryers Heating Appliances Kam, Security Systems:*
No.of Devices or Equivalent
No.of Water Kam, No.of No.of Data Wiring:
0
Signs Ballasts No.of Devices or Equivalent
o
No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
co
No.of Devices or Equivalent
E OTHER: towel bar, floor heat
-a Attach additional detail if desired,or as required by the Inspector of Wires.
o Estimated Value of Electrical Work: 2000.00 (When required by municipal policy.)
Work to Start: 1 0-1 7-24 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
Ei INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
U the licensee provides proof of liability insurance including"completed operation"coverage or its substantial� P P g equivalent. The
cti v undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE [a BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Crawford Electric w JLIC. NO.:13923A
Licensee: Richard Crawford Signature "� ..,.0 1_,,,_ LIC.NO.:23888
(If applicable,enter "exempt"in the license number line.) us.Tel.No.: 508-737-0194
Address: 84 Cranberry Lane, South Yarmouth MA. 02664 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 've this requirement. I am the(check one)❑owner El owner's agent.
Owner/Agent
Signature —' %' z Telephone No. I PERMIT FEE: $ 7$7)6