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Home My WebLink AboutE-19-3259 I � Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-003259 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.I/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:11/28/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the eleCtrttatlwork described beloK. f Location(Street&Number) 312 dmf WINSLOW GRAY RD A� l (� 11/ 14 Owner or Tenant R TR Telephone No. Owner's Address THE KSK REVOCABLE TRUST, 12 GLEN RD, HYANNIS, MA 02601 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 kitchen&bath room. 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- ❑ No.of Emergency Lighting grnd. Arnd. 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 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: Jeffrey T Foss Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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 _ l.ommoruora�oil aasac fff Official Use Only ,y ry c7 �7 C(q_3'2 meq i_ 1J parfnent of Tier J Permit No. int r j j rrvicr! r7 • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked /SO2) ev. 1/07) ' (leave blank) • • APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 12. N. (PLE4SEPRAT ININK ORTYPE ALL INFORMATIO Date: /2 City or Town of: YARMOUTH To the Inspe tar o Wiresf : . By this application the undersigned gives •otice of his or her intention to perform the electrical work • cribed below. . Location (Street&Number) I A ( ) n 11 OwnerorTenant /I Milia 41d ftfn Telephone No. I , 34—021 reOwner's Address ,____14 Is this permit in conjunction with a building permit? Yes K. No 0 (Check Appropriate Box) Cl (� PP Pete z Purpose of Building Utility Authorization No. Wm y Ezistitrg Service /do Ams ��0 /20gr ❑ No.of Meters � FVolts Overhead Und d N is $ eco Service Amps / Volts Overhead Undgrd❑ No.of Meters a W r- ill umber of Feeders and Ampacity cation and Nature of Proposed ectri Work:or 5 i� V '4 v z i.._ 9 ,/g6-s /iS/ik eget( l# Jr,1t • eiv gaee ' `` - , ' � ' 2 �/ " FS '1 /d'e�✓�t/ .� -�m Completion of the olt ngtable 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 Abo ❑ In- No.of-Emergency Lighting ¢endve. Brod. 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 Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number (Tons I KW No.of Self-Contained 1 Totals: Detection/Alerting Devices Municipal •No.of Dishwashers S aceArea Heating KWLocal Connection ❑ Otherv No.of Dryers Heating Appliances Kw Security Systems:• No.of Water No.of No.of No.of Devices or Equivalent Heater KW Data Wiring `\� Signs Ballasts No.of Devices or Equivalent \ No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OT OTHER — • Attach ad*fond detail(desired or as re Estimated Value of E c al Work: e------ ga red by the Inspector of Fares. (Whey required by municipal policy.) Work to Start II a7 �8"..-- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 ofa to the permit issuing office., JO v.. CHECK ONE: INSURANCE ( BOND 01 OTHER 0 (Specify:) cr7/�I� PIL e 't CO fi, I carni", under the pains and penalties of perjury,that the information on this application fs true and complete, - FIRM NAME: /�jl�� t LIC.NO.: Licensee: C( /( 7.j� Signature �,/ t / LIC.NO.:L �j ajapplicabl t "erg apt 1 rise is a berg lin ) Bus.Tel.No: �j Address: _5 C./ (/ j �d/��/ � A016 / Alt Tel.No.:'' V ' /6 67r j 'Per M.G.L.c. 147,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 ❑owner's agent. s Owner/Agentg Signature• Telephone No. 1 PERMIT FEE: $