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Home My WebLink AboutBLDE-19-001897 or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-001897 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (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:10/1/2018 City or Town of: YARMOUTH To the Inspector of Wires. By this application the undersigned gives notice of his or her Intention to perlorm the electrical work described below. Location(Street&Number) 28 GINGERBREAD LN Owner or Tenant MATHESON WILLIAM N JR Telephone No. Owner's Address MATHESON JANICE D,28 GINGERBREAD LN,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 0 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 Cell: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 _ 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 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 Slens 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:) J 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 g166t 0/III et +vO1-c k' frI18 W .:a 0.1 en.;,..,.. . -; 4maiacke� • QUe ty q 7• JsParfnwnE Eva,Services Permit No.mow _;II= Occupancyand FeeChecked- BOARD OF FIRE PREVENTION REGULATIONS 1/01 ' pevblank) _ • N APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 FN. (PLEASE PRINT IN INK OR TITEALL INFORMA77ON) Date: /O— /-/g ' ' City or Town of: YARMOUTH To the Inspector of Wires: . By this application the lmdersigned gives notice of his or her intention to perform the electrical work described below. cation (Street&Number) 0-- Z�° 1nA l haps�►'�zcr! �(� i�P WOwner'orTenant YVI14-4-)lfc 0 ) i lJ l Telephone No. m • I > oasO,wner'sAddress r afsl:his permit in conjunction with a building permit? Yes R No 0 (Check Appropriate Box) 1.1.1 °OP se of Building 'P ti-tl k t vtts. Utility Authorization No. U c_ o sting Service Amps / Volts Overhead 0 Und LIl gid❑ No.of Meters view ServiceAmps ❑ Undgrd Umber of Feeders and Ampacity / Volts Overhead gid 0 Na.of Meters Location and Nature of Proposed Electrical Work: t \_e_ke.it Z.& wjL \ Completion of the followingtable may be waived try the Inspector of Wires. No.of Recessed Luminaires Na of Ceil�nsp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators ICVA - a .. No.of Luminaires Swimming pool Above ❑ In- No,of Emergency Lighting r grnd grad. 0 Battery Units jNo.of Receptacle Outlets . No.of Orn Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices sk.N( No.of Ranges No.of Mr Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No,of Self Contained Totals: eteetion/Alerting Devices V No.of Dishwashers Space/Area Heating KW' Municipal [ool Connection ? A, No.of Dryers Heating Appliances KW Security Systems:" No.of Water No.of No.of Devices or Equivalent U Heaters KW Signs Ballasts Data Wiring: Na of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: — No.of Devices or Equivalent _ w OTHER: .>„... Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3 9)o t) (When required by municipal policy.) ( .' Work to Start: 1 b—I/a 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 Er BOND 0 OTHER.[] (Specify.) I certify, under d penalties ofperjuinformation on,. _ el Nn/l1 ic• n is true and complete.NAME: ` S Su.�that the I L V i --t - LIC.NO.: t/ Licensee: Use/ Signatu /� LIC.NO.: ""—"' (If applicable,enter"exempt"in the license bee li e Address S�� Bus.Tel.No. /G • j *Per M.G.L.c. 147,s.$7-61, 'ty work requires a .artarent of Public SafetyAlt.Tel.No.:_ — OWNER'S INSURANCE WAIVER: I am awar 4 at the Licensee does not have the liability insurance coverage n Q required bylaw. Bymysignature qw below,I hereby waive this requirement. I am the(check one)D owner 0 owner's agent Owner/Agent Signature. Telephone No. I PERMIT FEE: $ 7c