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Home My WebLink AboutBLDE-19-003054 Commonwealth of Official Use Only ` Massachusetts Permit No. BLDE-19-003054 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ` JRev.1/07] — 1 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 IT LINK OR TYPE ALL INFORMATION) Date:11/19/2018 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 electrical work described below. Location(Street&Number) 43 KENCOMSETT CIR • Owner or Tenant DEBRA SHORES Telephone No. Owner's Address 43 KENCOMSETT CIR,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 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 1st floor 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 No.of Luminaires Swimming Pool Above ❑ In- ElNo.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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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:) /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 WAOUOIT 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 F /(—(?—(8 4� c'4 Iif 7Ic0 , _ Comm; of M7auac fit OOffi/cial�Use Only = nt JJsParfmcrrE of.lin.� •Permit No. -1� 3 Qgi '�f_ crvices Occupancy and Fee Checked z_ BOARD OF FIRE PREVENTION REGULATIONS -Rev. I/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 1700 (PLEASE PRINT ININK ORTYPE ALL INFORMATIOA9 Date: 11-- 6 -/R City or Town of: YARMOUTH To the Inspector of Wires: B}!this application the undersigned gives notice of his or her intention to perform the electrical work described below. - _: ovation(Street&Number) t : ,,D g _plcco ' on(Street 1) e 5n. keoN e Dh1se,r Io l ` ^ O�CV 1 nr-il,l r s Address G hL� Telephone No._—_ N. W cc I oatl permit in conjunction with a b tiding permit? Yes o- No 0 (Check Appropriate Box) i;tom se of Building t (i I z Utility Authorization No, o r� W FI Service Amps / Volts Overhead Q Undgrd L ew nice ❑ No.of Meters te Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampadty • Location and Nature of Proposed Electrical Work: 1 .54-F./ /� �fn� Od-t" A�e Completion of thefail7WilIqtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cerl.Snsp.(Paddle)Fans • No.of Total Transformers ICVA _ No.of Luminaire Outlets No.of Hot Tubs Generators ICVA No,of Luminaires Swimming Pool Above in- No.oftry Lighting Aboc. in-d. ❑ Battery Units No.of Receptacle Outlets No.of OH Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and J • Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons IKW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating ICW' Local o Municipal Connection Oda No.of Dryers. Heating Appliances Kw Security Systems:' No.of Water No.of No.of Devices or Equivalent No,of Heaters KW Signs Ballasts Data Wiring No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring OTHER: Na.of Devices or Equivalent • Attach additional detail f desired or as required by the Inspector of Wires. 9� Estimated Value of Electrical Work (When required by municipal policy.) Work to Start 4—,./1 -'Y 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 [-BOND ❑ OTHER 0 (Specify:) I certtfy, under the pains an. . -. ' s of perjuppothyhe information on this ap.(!cation is true and comp,FIRM NAME: iii r LIC.NO �...-•"" Licensee: - en/ Signature 4,' lir LIC.NO.: (Ifapplicable,enter"ezggm in in the license number line) — Addresr. �i �!/ll'GSL Bus.TeL No.: J 'Per M.G.L. . 147, 57 securitywork requiresAlt.Tel.No.:____________aepar4ment of Public Safety"5"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(cheek one)0 owner 0 owner's a eat t Owner/Agent d Signature Telephone No. 1 PERMIT FEE: $ 76 I