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Home My WebLink AboutE-19-1876 -- t Simmonwealth of i Official Use Only t( Massachusetts Permit No. BLDE-19-001976 • C BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:10/1/2019 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) 117 BREEZY POINT RD Owner or Tenant ELLIS SUZANNE Telephone No. Owner's Address 117 BREEZY POINT RD, SOUTH YARMOUTH,MA 02664 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 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel kitchen&wire addition. 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 Ab0 In- CINo,of Emergency Lighting grnove d. 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 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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: DAVID W SPRINGER Licensee: David W Springer Signature LIC.NO.: 21170 (lfapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter,Hyannis MA 026012106 Mt.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 aoceits 14 110 (CG jc (Q1( ale sem - l-ammoraven&oil Madrac tfs ' Official Use Only v- cc''y�' Th pp 2apartment of Thre Jenrker . Permit No. s'I 1==- Occupancy and Fee Checked 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: ter /( ? 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) 1 11 SR°ez J N ,fib k k rd .5 y n oV+ Owner hr Tenant S 1.1.e., E t 1 i 5 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Cheek Appropriate Box) Purpose of Building d aid kin Utility Authorization No. Existing Service Amps / Volts Overhead❑, Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: A ac{�/^ Ara K1+di en t.e St.\ Completion oJthe following,table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL Snsp.(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.oThmergeacy Lighting - grttd. arnd. ❑ Battery Units No.of Receptacle Outlets . No.of Oil 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 Coot Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number (Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loral Municipal Q Connection ❑ O:117 No.of Dryers Heating Appliances KW Security Systems:* No,of Water No.ofNo.of Devices or Equivalent Heaters N° of Data Wiring: Sighs 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 Wirer. Estimated Value of Elp ctrical WorE 5;000."- (When required by municipal policy.) Work to Start toil /It 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 in ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coven sin force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) f cent)",under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: .5prirfix f(cdrrc. LIC.NO.: tI 7OA Licensee:}:&UZ.t Sprrnrr Signature d—)/1/4.--rLTC.NO.:_ $23q 3 (If applicable,enter"spem t"in th license number ire.) rc • Bus.Tel.No.;_.�$ a4t{ OI Sq Address, 70 nr31W S '.\attt4t`'c j `Per M.G.L.c. 147,s.57-61,security required Department of Public Safety"5"License: Alt. Lic4No. �- - 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)❑owner 0 owner's agent t Owner/Agent Signature Telephone No. I PERMIT FEE: $