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Home My WebLink AboutBLDE-18-004065 a N. Commonwealth of Official Use Only ti�1" l Massachusetts Permit No. BLDE-18-004065 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.1/07j 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:1/19/2018 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 elecntcalpojt described below Location(Street&Number) 1214 GREAT ISLAND RD / ALR-Ca A21\11 OK Owner or Tenant SALTONSTALL THOMAS B Telephone No. Owner's Address CIO ELIZABETH Z CHACE,46 ABORN ST 4TH FLOOR, PROVIDENCE, RI 02903 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 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: Renovation of bath rooms,kitchen&basement. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 19 No.of Ceil:Susp.(Paddle)Fans 2 No.of Total Transformers KVA No.of Luminaire Outlets 2 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- a No.of Emergency Lighting 'pa! grnd. Battery Units No.of Receptacle Outlets 26 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 30 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Ileat Pump Number Tons KW No.of Self-Contained Totals: ,Detection/Alerting Devices No.of Dishwashers 2 Space/Area Heating KW Local 0 Municipal 0 Other. Connection No.of Dryers 1 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: Jay A Donnelly Licensee: Jay A Donnelly Signature LIC.NO.: 15717 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 158 PINE ST, RAYNHAM MA 027671121 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:$12100 eart 1/243 fix T5. , "ph s te_. aCM (llq/f6 te— r v /ommnnuea/h of Mqu at • . • oi Vse Only � Permit No. J ,,nn ///S�ntrapartment o{7ir.&, ites Occupancy and Foe Checked BOARD OF FIRE PREVENTION REGULATIONS {Rev. Iro77 ' peave blur!) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordance villa the Massacbusens Electrical Code(MEC),527 CMR 12.00 (PLEASEPP�DJT WINK OR TYPE ALL DVFORM4TI0T\) Date: /—/Z.ZQ City or Town of: YARMOUTH m the Inspector of Wires: . By this application the pndersigned gees notice of his or her intention to perform the electrical work described below. • Location(Street&Number) /e7/ygie_ettr,r5Zw,d R n • Ownefor Tenant meG G A 10 ktreek /J` Telephone No. Owner's Address c.5-79/11e— _____________ -t Is this permit in conjunction with a building permit? Yes L..."----No E (Check Appropriate Box) 0 1—' a urpose of Banding ��JJ Z lCO�� C Utility Author zation No. 1 LU m 2 misting Service Cy Amps Joh/� Votts Overhead 0E. Undgrd� No, of Meters _ �. `ti New Service amps / Volts Overhead❑ Undgrd ❑ NO.of Meters Wff Nuber of Feeders and 4mpseiry —V Location and Nature of Proposed Electrical Work: t �itlser�, 17 c�dv,,,s- ,_,moEgri/g ix 5 Completion of the follow ,z table may be waived by the Inspector of Wires. No.of Recessed LnmiaairesNoof Celt-S (Paddle)I , e usP (pae)FansO�J INo.raasofformera TVA. C TKA Na, of Luminaire Outlets a 'No.of Hot Tabs Gators • KVA ' No.of Luminaires 6. ISwimm;ag Pool Above ❑ In- ❑ [t3 Natteryo.or t,mtergency Lzgnrmg circle !rude nits No. of Receptacle Outlets 025, No.of Oil Burners !FERE ALARMS INo,of Zones Na.of SwitchesNa of Detection and 30 No.of Gas Burners tnitw�Dews No.of Ranges / INo.of Air Cond. Tons �No.of Alerting Devices C' No.of Waste Disposers Meet Primp I Number Tons KW (No,of Self-Coataiaed .VVC Tota ts: lDetection/Alertino Devices No.of Dishwashers o2 Loccl Space/Area Heating KM>�apal I W' �Connection 0 0th?r No.of Dryers / !Heating Appliances KW Security Systems:• "`�� No. of Water No.of Devices or Equivalent k Heaters INo. Siof No.of `� KW .SiOIS Ballasts DataNa of evices or Equivalent No. Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent tl OTHER _ Estimated Value of Electrical Work Attach ex/di/fond detail Ordered or as required by the Inspector of 3rer. in (When required by municipal policy.) Sr j Work to Start A/9-49 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 a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 9 (Specify;) I certify, under the plias and penin s ofperf ray,that the information on this application is true and complete. FIRM NAME: D fit Der /f f/ f/ G7/j.Z- G LIC NO.:Alzr2e2. Licensee: /(/ Signature LIC.Q (Jfapplicable,en er exempt"; the license ber lin Bus.TeLNo.:Addressr - f f. A . a / if, Alt TeL No.:------ J `Per M.G.L.c. 147,s. 7-61,security work requires Department of' bile Safety"S"License: Lie.No. ______________ — OWNER'S INSURANCE WAIVER I am aware that the Licensee does nor 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 al Si I PERMIT FEE: $ ! Signature Telephone No.