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Home My WebLink AboutBLDE-19-000361 A Commonwealth of Official Use Only kik Massachusetts Permit No. BLDE-19-000361 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/071 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:7/17/2018 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 IRONWOOD COURT Owner or Tenant MARHEVKA JOHN S Telephone No. Owner's Address MARHEVKA VIRGINIA C, 11 IRONWOOD CT,YARMOUTH PORT,MA 02675 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 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel bathroom. 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 ❑ 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 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Coml. 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 Data Wiring: Heaters ,Stens 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 ❑ BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: THOMAS P SULLIVAN Licensee: Thomas P Sullivan Signature LIC.NO.: 18182 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 WAQUOIT RD,COTUIT MA 026353517 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 cal)tott 7) jolta t cp.) nn ryy� \ ammonwsa&of tr/aasac it • Official Use Only _.---- = 11 Theparfm of o f.t7ire&vices Permit No. (/Q� `/ j'� , Occupancy and Fee Checked /s p7� BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07] • (leave blank) 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— /7—/9 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. w cation(StreetorTenant V &Number) 1 l i 0A) iv n o n G j er }4'j yt � m k Telephone No. 11 > o k-9 er's Address 7,_ 11.11 this permit in conjunction with a building permit? Yes EL— No 0 (Check Appropriate Box) Iii .--i P rpase of Building � I,(/ ,yf Utility Authorization No, J 9 0 S E isting Service Amps / " Volts Overhead 0 Undgrd❑ No.of Meters . 0 N w Service _ Amps / Volts Overhead 0 Undgrd 0 Ni.of Meters D`" wl m�Feeders and Ampacity Location and Nature of Proposed Electrical Work: "`i2 &4 rn�i - -(:) , ,0 d t- / Completion of thefollawinziable may be waived ly the Inspector of{Fuer. - 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 ttery EmergencyUnits Lighting girdgird. 0 Ba 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. Ton No.of Alerting Devices • No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals:I I`�- Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LocalMunicipal ❑Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:' No.of WaterNo.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: 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 denral or as required by the Inspector of Wires. Estimated Value of Electrical World ad'ete,---" (When required by municipal policy.) Work to Start: 7."-Vir/F 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 0 OTHER ❑ (Specify:) I cest)5 under th t:fnd penalties ofperjury,that the inforne:to y application is true and complete FIRM NAME: �..../....._..- /-e LIC.NO.:a7 Licensee: 't /tom e Signature,/�� LIC.NO.: (If applicable,enter"aempe in the is- e number line.) Bus.Tel.No: Address A"--- -........i q .,� G j `Per M.G.L. c. 147,s.5 -61,security work requires De a.. ent of Public SafetyAlt.Tel.No.�- I//cSril OWNER'S INSURANCE WAIVER: I am aware that, e Licensee does not have the liability insurance coverage nrnally �t required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent t Owner/Agent Signature Telephone No. I PERMIT FEE: 5