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Home My WebLink AboutE-19-390 oe Commonwealth of Official Use Only EtaMassachusetts Permit No. BLDE-19-000390 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/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:7/18/2018 City or Town of: YARMOUTH To the Inspector of Wires. By this application the undersigned gives notice of his ur her intention to!victor, c electrical work d-se r'bed below. Location(Street&Number) 86 LOOKOUT RD C... ! • • I • ON) Owner or Tenant --- z Telephone No. Owner's Address Ir Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead El Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate panel&remodel master bedroom&bath. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 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 0 In- ❑ No.of Emergency Lighting 'roll*? grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Data Wiring: 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: (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: JONATHAN R HALL Licensee: Jonathan R Hall Signature LIC.NO.: 11925 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:263 CAMMETT RD,MARSTONS MLS MA 026481585 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 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:$7100 eu(et! �j(Cd B U 7a k3 (4e lite ;-174,--‘,"1:1 -,..- c"-'1� �.� ammo. oil t r eseeach,ttf Official Use Only 0 T , •t,s cam' c� �7 ECS — 05% zllrs' apartment o f 7bm- ernrue Permit No. O'=_=_ ' Occupancy and Fee Checked e� /•,.a BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07) ' (leave APPLICATION 'FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: City or Town of: YARMOUTH To the Inspector of Wires: • . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. c't Location(Street&Number) �(, LOOkort ) yatrA .14. OwnerorTenant Crecol c\ j ASOA Telephone No. Owner's Address t�e (Ge`\Qer)- F' P fplY-S3�$lj Is this permit in conjunction with a building permit? Yes No 0 (Check Appropriate Box) Purpose of Building Re C Utility Authorization No. Existing Service_ Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead 0 Undgrd� 0 Ni.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: St � t rta _ L V ` C.. IcAuVVf- QprvCk ( c\ 3 tk .ot C':At mplettonithe following.table may be waived by the Inspector of Wires. No.of Recessed Luminaires Na.of CeiLSnsp.(Paddle)Fans No.of Total Transformer KVA _ No.of Luminaire Outlets •No.of Hot Tubs Generators KVA •• No.of Luminaires Swimming Pool Above 0 In- No-of Emergency Lighting grad. orad. Battery Units • No.of Receptacle Outlets No.of OB Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Hest Pump I Number I Tons j KW No.of Self Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection Der No.of Dryers Heating Appliances KW Security Systems:' No.of Water No.of Devices or Equivalent Heaters No.of No.of Signs Ballasts DataW of Wig:KW 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 Eleccall World ?Lim (When required by municipal policy.) 6 Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 pains and penalties of perjuty,that the information on this application is trite and complete. FIRM NAME: SQ,ta kap ZktfitZ,°h LW.NO.: Licensee: )-,-q/),q U0.1 I Signaturei� LW.NO.: (if-applicable,enter"exempt"in the license number line) Bus.Tel-No-•Cab Rh 51.0 Address: 26? rt--MMt�a ick �/»flvt ry \\S Alt.Tel. No-:_� j Per M.O. 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/Agent by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner 0 owner's agent. Signature Telephone No. I PERMIT FEE: S