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Home My WebLink AboutBLDE-19-000590 ;,` Or Commonwealth of Official Use Only aiLlMassachusetts Permit No. BLDE-19-000590 � BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:7/30/2018 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) 36 WILDFLOWER VILLAGE Owner or Tenant GARNICK ELLEN B TR Telephone No. Owner's Address THE 36 WILDFLOWER LN RLTY TRUST,36 WILDFLOWER VILLAGE,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) / Purpose of Building Utility Authorization No. — Existing Service Amps Volts Overhead ❑ 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 J No.of Luminaires Swimming Pool Above 0 In- CINo.of Emergency Lighting Rind. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas BurnersNo.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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Enuivalent No.of Water KW No.of No.of Data Wiring: Heaters Slons Ballasts No.of Devices or Enuivalent 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: 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 -Ile Y3) 1I6 ge-t,& 0/3(« 1 - ` C cp< « (l8 ______ e y� _ = ammo. monun&of rr/aedac rte Official Use Only _tea _• ccyy cc77 p r=nii<• 1Jspartmsn(of Jin Serviced Permit No. =_it r Occupancy and Fee Checked ------- VI � ��P- 1/4 BOARD OF FIRE PREVENTION REGULATIONS cv. 1/07j \�/" i (leave blank) «l/// 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 ^ 3/.-/ef ' 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) L? 6 4U/ /d F/"a't' e Owner orTenant )1,7"AAJ 2..-P f I `` Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ' Purpose of Building Utility Authorization No. lExisting Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity • 1:______.------Location-- Iand Nature of Proposed Electrical Work: errs 4...):3/44...):3/4a R )me ((e 1- �!] m Yom` 1 �Coompletion of thefollowinztable may be waived by the Inspector of Wires. 0c.t 0a No.of CeiL-Svsp.(Paddle)Fans • Transformers KVA 0.of Recessed Luminaires No.of Total � _ O o lqp.of Luminaire Outlets No.of Hot Tubs Generators VA I�pK i of Luminaires Swimming Pool Above ❑ [n- ❑ No.at Lmergency trghang (,) J ` 1 t;rnd. grnd. Battery Units } lr Nen of Receptacle Outlets No.of Oil Burners Lal FIRE ALARMS INo.of Zones �� No'of Switches No.of Cu Burners No.of Detection and ILS f""`1 • ' • Initiating Devices — No.of Ranges No.of Mr Coed Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LoralMnnlcipa! O Connection ❑ Chh? No.of Dryers Heating Appliances IAV Security Systems:* No.of Water No.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!/desired or as required by the Inspector of Wires. Estimated Value of Electrical World /` ro 0 (When required by municipal policy.) r gt Work to Start 7--z,0—/Y Inspectionsto be requested in accordance with MEC Rule 10,and upon completion. (�1 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 tenth',under the pains and penalties of perjuzy,that the information o application is true and complete. FIRM NAME: j.t SVUlf/a,t9 rr'/r./'fJTrZ LIC.NO.: J2 Licensee:koy4 c sd.,4if L—t. Signature i/1dj� LIC.NO.. (If applicable,enter"exempt"in the license number fine.) i Bus.Tel.No.: %t___________ !U ^t-y//� Address. 7 f U/ uevl ..e d C-'/- Alt. J `Per M.G.L. c. 147,s.57-61‘securitywork requiresAlt TeL No.: OWNER'S INSURANCE WAIVER: I am are that Department sees does not have the liability insurance coverage normally e: Lic. No. Q required bylaw. Bymysignature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's a ent t Owner/Agent j Signature Telephone No. I PERMIT FEE:S �) V