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Home My WebLink AboutBLDE-19-002168 A.7: Commonwealth of OfTicialUseOnly /'4 \ Massachusetts Permit No. BLDE-19-002168 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 ALLINFORMATION) Date:10/11/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention t erttrn\the electrical w rk scribed below. Location(Street&Number) 301 HIGHBANK RD L_1 v 14-1- Owner or Tenant F Telephone No. Owner's Address M.301 HIGHBANK ROAD,SOUTH YARMOUTH,MA 02664 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 ❑ No.of Meters New Service - Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Kitchen remodel&fan/lights in bedrooms. 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 i Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In• o 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers (feat 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 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) -17c 7„'2- 4( �Jf I certify,under the pains and penalties of perjury,that the information on this application is true and complete "1 FIRM NAME: Cathy L Harland Sanders Licensee: Cathy L Harland Sanders Signature LIC.NO.: 37505 (If applicable,enter"exempt"in the license number line.) - Bus.Tel.No.: Address:75 S EASTHAM ST,EASTHAM MA 026422657 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: $75.00 ad. ca/ b 8 AI MA/ah o /cz/,`ts✓. A i RECEIVED rf a 11 2018 o monweatth of tr/addachirdelid ,aei issc .‘i,..3 • G r7� rt ��}j [7 Permit No. (`C M 1 e ariarenf of..1iro Serviced U' ;gG DEFgRTM T p Occupancy and Fee Checked t'I :PAR()OFF E PREVENTION REGULATIONS Rev, 1/07] (leave blank) C . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),127 CMR 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /0/ // / 19 ea City or Town of: Var the d To the Inspector of Wiles: By this application the undersigned Ives notice of his r her intention to perform the electrical work�d/tscribed below. N Location(Street&Number)1 30 / /9 4 hen E. IC C I F Owner or Tenant Gr1 e n c$-Z. C. Lt Li J{1 c-rt, Telephone No. O8- 360-/16 3 Owner's Address .5 4h7 P_ CO Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) • QPurpose of Building re 5Irit- -- C_ t_- Utility Authorization No. Existing Service a CO Amps J?/ cpctVolts Overhead❑ Undgrd,j No.of Meters ▪ New Service _ Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity I V t Location and Nature of Proposed Electrical Work: 17 ch en re,nn o Jet, J n L4-5 •. QARfi-6-01S reroUe c1 cud U7ire-5 iia IC + e Din in1tz_vv- f2J.j Completion of Ute following�toble may be waived by the Inspector of Wires. Tal i.5 No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. KVA 0 q . No.of Luminaire Outlets No.of Hot Tubs Generators KVA Ca No.of Luminaires Swimmin Pool Above in- No.of Emergency Lighting ✓ g mid. grnd. Battery Units ^i No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices 11,I 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 P Totals: "` Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ MCunicipalonnection 0 Other No.of Dryers Heating Appliances KW Secu oyf Devies:* s or Equivalent No.of Water No.of Na.of Data Wiring: Heaters KWSigns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telof Devic soorsEquivalent 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: 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 0 BOND 0 OTHER Q (Specify:) I certify,under the pain. .nd pe 'Tries of pe ' •' that t!a information j t,is app! atlon s true and complete. r/�^ FIRM NAME: ��b�a�a, � • a ' 4S t idJ LIC.NO.:complete. St Licensee: ( 17lltTA I L Signature 0f4 Y�l Al LIC.NO.: (If applicable,enter"ex pt"in t. license member lin_ 477 ? .1 Bus.Tel.No: 7 741 - 7010?-4/0/ Address: . ... . ‘11.—' a ' It.Tel.No.: *Per M.G.L.c. l'7,s.57-61,security work requires Department of Public Safety"S"License: Lic.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(check one)0 owner 0 owner's agent Owner/AgentPERMIT FEE:$ SignatureTelephone No.