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Home My WebLink AboutBLDE-18-005321 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-005321 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked fRev.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:3/27/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 14 HILLSEA RD Owner or Tenant LAKIS STEPHEN G CO-TRS Telephone No. Owner's Address LAKIS EVELENE M CO-TRS, 14 HILLSEA RD,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 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel kitchen. 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 Cond. .TootanQl No.of Alerting Devices No.of Waste Disposers Ileat Pump Number Tons I 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 IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Val Electrical Work: (When required by municipal policy.) Work to st 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: ALEXANDER LATIMER Licensee: ALEXANDER LATIMER Signature LIC.NO.: 54173 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:64 ROUND COVE RD, HARWICH MA 02645 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:$75.00 at,96,1 9 ne , NAL, (\\4 /� �y�j /l�oorc of//lalaael-.udeiti Of-cartel Use _T= partment of a...,)eroiae .. 'Pt No._ Occupancy and Fee Checked BOARD OF RE PREVENTION REGULATIONSRev. 1/07) (leave blank) APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electical Code(MEC),527 CMR I LOO (PLEASE.PRINT pIINK ORTYRE ALL INFOR.W17019 Date:_t3—a7-fit& City or Town of: YARMOUTH To the Inspector of Wires: dQ . By this application the yndersiped gives notice of Es orrher intention to perform the electrical work described below. C..1y /A " Location (Street&Number)� en Rd. oa€ 7s to OwneforTenant S-3/4-erlipn G. /ci k�• Telephone No. •a Owner's Address r 1 Cl 1 Is this permit in conjunction with a building permit? Yes %...„ No ❑ (Check Appropriate Boz) 0 lA1 Purpose of Building -. Utility Authorization No.0 ' - J t. Existing No.of Meters Service_ IIndgrd❑ _ a Amps / Volts Overfiead ❑ 1 w est New Service _ Amps / Volts Overhead E Undgrd❑ No.of Meters ii a yyy,,,,,,R�' I Number of Feeders and Ampacity • ltJ I Location and Nature of Proposed Electrical Work^. to `4rtd�n Steel_ —"� Completion of the fol:wine table may be waived by the Inspector of r ome. i ' No.of Recessed Luminaires No.of Ceti-S• )addIe Fans INo,of Total Q1 �' Transformers KVA S No. of Luminaire Outle4 No.uiHot Tubs IG-aerators CVA �?�" No. of Lumfr:afres swhiu,,;"g Pool - BAbove In- No.attery or sn. ergency Lighg - Umnits tin arnd. 0 grad. No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS IND.of Zones No. of Switches No.of Gas Burners Na of Detection and - • • Initiating Devices No.of Ranges No. of Air Cond. Tolo-ns No.of Alerting Devices • No.of Waste Disposers Heat Pump-'umber I'Tons I KW No.of,Self-Contained Totals: Demotion/Merlins Devices No.of Dishwashers Spate/Area Heating KW Local❑ Mttaic it Connection 0 Other No. of Dryers Heating Appliances KW Security Systerns:*No.of No.of Water eaters KW ter No. of No.of Data Wiring: Devices or Equivalent Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na.of Devices or Equivalent OTHER - Attach additional detail if desired or as required by the Inspector of Pvt. Estimated Value of Electrical Wort (When required by municipal policy.) Work to Start 3-e2:7`aokg 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify, ander the npains and pexrIMPs of per]WP,that the information on this FIRMNAME:_L7(oc tk / f aPPrtcaBoxittrae CXC.nd :O.: nE: e i ElPgnatnrrare Y1 LIC.NO.: L�f 7 -8 Licensee:/7 �, tf' Signature,/�g,��!�TT1i LIC.NO.: (.7f applicable, enter "exempt"i- t 'Ifeense'mm•er 1' :.) Address: • .. / ` Bus.TeL No.: 422 ata •a,. Lf • 4- • • tae.. - -I i �i Alt TeL No.: J `Per M.G.L. e. 147,s.57-61,security work quires Department of Public Safety"S"License: Lie.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. I am the(check one)0 owner 0 owner's agent r Owner/Agent Sign iSigTelephone No. . I PERMIT FEE: $