HomeMy WebLinkAboutE-19-3365 Commonwealth of Official Use Only
IfE. Massachusetts Permit No. BLDE-19-003365
BOARD OF FIRE PREVENTION REGULATIONS Occupane an4 Fee Checked
(Rev.l/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:12/4/2018
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 cicctncal work described below.
Location(Street&Number) 23 WINDSWEPT PATH
Owner or Tenant MARSHALL-WRIGHTSMAN JANE Telephone No.
Owner's Address 83 WHEELER RD,MARSTONS MILLS, MA 02648
Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Wiring for new sunroom.
Completion of the following table may be waived by the Inspector of ires.
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 0 In- ElNo.of Emergency Lighting
grnd. grnd. Battery Units
No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones /
No.of Switches 4 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 0 Municipal ❑ Other:
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No,of Devices or Equivalent
No.of Water Ip No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs i 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 ❑ OTHER 0 (Specify:)
/certify,under the pains and penalties ofperjury,that the information on this application is true and complete.
FIRM NAME: JAMES B JONES
Licensee: James B Jones Signature LIC.NO.: 12351
(If applicable enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 118 MAPLE ST,HYANNIS MA 026015746 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 Teeehone No. PERMIT FEE:$75.00
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Cimtilmonw.aS of Mic �n el& O mai' USC Iy
a n 2eparfinenE o f.lire.ferviu! • .Permit No. ✓ �Gs
I Occupancy and Fee Checked 5
BOARD OF FIRE PREVENTION REGULATIONS n. 1/07] ' (leave blank)
APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code C),5 7 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALLINFORMA77Ol9 Date: 1 3 90iS
City or Town of: YARMOUTH To the lizsp ctor of Wires:
. By this application the pndersigne�s noticeof his or her intention to ,perform the electrical work described below. •
. Location(Street&Number) t , __11 tLL
L
.Owner*or Tenant 3 J t-kh w.Ic..L ns LJ —r& s Telephone No.
Owner's Address See- ",e, �_
c..S
' Is this permit in conjunction with a building permit? Yes No
• Purpose of Building V‘.19-,--.) Sv,��a•„/� ....0 (Check Appropriate Box)
Utility_AaffiotizstionNo.
Existing Service ,tC Amps Ix/ ' Lrdt�tVolts Overhead ❑ Und �t I
No.of Meters
New Service _ Amps / Volts Overhead❑ Undgrd ❑ No,of Meters
1~—'--"'N����canmber of Feeders and Ampacity -
a 1 w dation and Nature of Proposed Electrical Worts
•
j� — �i- W.ti N:1..4 &..1.sfoo.n
5
c'v a Campfetiort of the fallowing table may be waived the Inspector
c''J byttalcue Wires.
o.of Recessed Luminaires No.of
Il,I ca Q ✓A No.of Cet1-Susp-(Paddle)Fans Transformers ICVA
fJ LU 1/�'`�C" o.of Luminaire Outlets No.of Hot Tubs Generators ICVA
LU i so,of Lvmfaaita Swimming Pool Above la- "No.of Emergency Lighting -
arnd rnd. 0 Batten'Units
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