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Home My WebLink AboutBlde-19-007086 Commonwealth of Official Use Only rt. Massachusetts Permit No. BLDE-19-007086 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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 ALL INFORMATION) Date:6/17/2019 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 reytneal work gibed below. Location(Street&Number) 159 PINE GROVE RD 1140L `6- Owner or Tenant JUDGE MARK R Telephone No. Owner's Address JUDGE MARIA L,36 APPLETREE LN, PORTLAND, CT 06480 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: Wiring of addition. 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. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 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 ❑ 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: TIMOTHY M CAYTON Licensee: Timothy M Cayton Signature LIC.NO.: 28200 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:251 DAVIS RD,WESTPORT MA 027903439 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 otie) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 A '?(3(t K 4i5 'zk(/9e t�4 c- 6((lc`i a_, C.,omm.onwea[lh o'MaJJacIui el Official Use On! =AiV cc'�� 7 Permit No. — ( 0 S) , t` .2)eparfntent o`.. ire .Serviced Cr L ` J s� Occupancy and Fee Checked BOARD OF FiRE PREVENTION REGULATIONS [Rev. 11/99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(iMIEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6//tq// 1 City or Town of: (,/f,�.krjoc/ fr'►..V!-- To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) /si PINt G^-g0VIL 12 WOAD'a"Mk Owner or Tenant PAUL RI'-;rvew Telephone No. Owner's Address 5'/ Is this permit in conjunction with a building permit? Yes frr. No I I (Check Appropriate Box) Purpose of Building AO Iblregkt Utility Authorization No. Existing Service Amps / Volts Overhead j j Undgrd j j No. of Meters New Service Amps / Volts Overhead I I Undgrd I I No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: [rj 2( /3 panti,�F:/ /3 pV01/• / /20 Completion of the following table may be waived by the Inspector of Wires. No.of Total No. of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No. of Lighting Fixtures Swimming Pool orrrd. ❑ grad. ❑ Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS (No. of Zones `'No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total No. of Ranges No.of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump .Number Tons KW INo. of Self-Contained Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local ❑ Connection ❑ Other Heating Appliances KW Security Systems: No. of Dryers No.of Devices or Equivalent No. of Water No.of No.of Data Wiring: Heaters KW No. Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Devices or qui a: b No.of Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 A BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: .4),,poG•vx (When required by municipal policy.) Work to Start: 6//il.i`11. Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certifj•, under the pains anti penalties of perjury,that the information on this application is trite and complete. FIRI\I NAME: i ivrh / frx Cn LIC.NO.: .( t Licensee: T1' ti i C4 Signature LIC.NO.: (If applicable enter exempt the license mm+ er line.) p Bus.Tel.No.: 1+�Y pS7� Address: f.G. lax ell � a� a der)!O AIt.Tel.No.: OWNER' INSUR.ANCE'WA VER: I am awa e 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: S