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Home My WebLink AboutE-18-940 AP Commonwealth of Official Use Only y; Massachusetts Permit No. BLDE-18-000940 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:8/18/2017 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 electrical work described below. Location(Street&Number) 57 GENERAL LAWRENCE RD Owner or Tenant FELLS MARYANN Telephone No. Owner's Address EPPICH SALLY J,57 GENERAL LAWRENCE RD,SOUTH YARMOUTH,MA ,•., Is this permit in conjunction with a building permit? Yes ❑ No 0 a nate Box) Purpose of Building Utility Authorizat� �Tryj,"�(Q�. it Existing Service Amps Volts Overhead 0 Undgrt� � 1 1�/� New Service Amps Volts Overhead 0 Undgrd )'�+' �J iVoi .///o�� Number o Fs and AmProposed /V="J/1�.077/ Location and Nature of Proposed Electrical SVork: Remodel kitchen 41/4,4[ / /11/7 p Completion of the following table may be wZti>�• •f Inspector f2 No.of Recessed Luminaires 4 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- CINo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. ,T ootanyl No.of Alerting Devices No.of Waste Disposers 1 Ileat Pump Number Tons I KW__ No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 9 Other: Connection Systems:* No.of Dryers Heating Appliances KW Security. S No.of Devicess 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 Eauivalent OTHER: _ Attach additional detail fdesired 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: Arthur J Jordan Licensee: Arthur J Jordan Signature LIC.NO.: 53489 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:22 RED ROBIN RD, CRANSTON RI 029201229 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 F®c elute 7cE-- W' �/ air Commanrueaa eil�/77i/ ssaehuexb, Oineial Use On _��_- 2eparLment o/J+•a J .• Permit No. —�;_i crwsJ , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IM Rev. ._ (]czve Mail) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK .411 wort to be performed in accordance with the Massachusetts Electrical Cod:(MEC),527 Clot 12.00 (PLEASE PRINT IN INK ORTYPE AuINFORM4TI0 Date: City or Town of: YARVIOUTHM g// . 7 To the Inspector of Wires: . By this application the;ndersigned Ives notice of his or her intention to perform the electrical work described below. • Location (Street&Number) _.. C'7•eno L .Owner'or Tenant d/! Owner's Address a yamTelephone No. - Is this permit in conjunction with a building permit? Yes ❑ No 0 1 ,1-- Pm-pose of Building Utility ❑ (CheckAppropriate Box) al Authorization No. Existing Service Amps / Volts Overhead Q Un gid > ¢ New Service ❑ No.of Mets a I Amps / Volts Overhead❑ Undgr•d El NO. of Meters al p Number of Feeders and Antipathy o , i I Location and Nature of Proposed Electrical Wort,:. j „ ce , W O s<oa boo 0 J - 04 j t " - --- -._ . �/ Completion of the foflowin?table may be waived bythe Ir.. . .. . m m INo.of Recessed Luminaires I No of .rpectorofrer, No.of Ceil.Srsp.(Paddle)Fags ITraasformers Total No. of Luminaire 0¢tle� KVA No. 'Generators • KVA ' Na of Ltcmiaaires Swirt+miae Pool Above In_ INo.oI i:mergency U tuag - . 'rind. ❑ ernd. 0 Bsrrary Units No. of Receptacle Outlets e No.of Oil Btaners IFTi38 ALARMS INo.of Zones • No.of Switches ' No.of Gas Be-acus It of Detection and rn No.of Ranges Totalmatne Devices Na. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat P¢mp�Nnmber Tons KW Ito.of Self( ontafn d - Totals: Detection/AIertino Devices No.of Dishwashers ( Space/Area Heating KW I Munidgal Local 0 Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW Pt. of No.of Data Wiring: Sins Ballasts No.of Devices or Equivalent 1 No.Hydromassage Bathtubs INo. of Motors Total HP Telecommunications Wimp 0 l Jdr R No.of Devices or Equivalent • Estimated Value of Electrical World ID• A additional detail ifderired or as o J required by the Inspector ofWiret. Work m stars � � r� � 9'�by municipal policy.) INSURANCE COVERAGEUnless waivoe tby e the owner, rerequested no for the erfiin accordance with orrmanEC c a of e elect electrical work,and upon paygss the licensee provides proof of liability insurance including"completed o issue unless undersigned certifies that such c,ov, a is in force,and has exhibited proof f same to the permit issuing offi e. The equivalent CHECK ONE: INSURANCE L'Y BOND ❑ OTHER 0 (Specify;) I certify, under the pains and penrlAPs of petjthat the information on this application is true anal complete. FIRM NAME: LIC NO: Licensee: drCJI� or-d2 Signature (IfappGeabte, enter-C.4:5=12 LIC N0: Y�g license number 1' .. Address: .)7 � c' Bus.Tel.No.. 63 - l3y I Per M G.L C. 147,s.57-61,securityr�� k� Alt.Tel.No» OWNER'S INSURANCE Wq wort r quires Department of Public SafetyS"License: Lic.No. -�� ec rVER I am aware that the Licensee does not have the liability insurance coverage n�otmally S required by law. BBy my signature below,I hereby waive this requirement I am the(cheek one ❑ owner owner's a eat ' Signature Telep bone No. PERMIT FEE:S—_