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Home My WebLink AboutBlde-19-006977 Commonwealth of Official Use Only E` i Massachusetts Permit No. BLDE-19-006977 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.1/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO 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:6/11/2019 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 electrical work described below. Location(Street&Number) 28 GINGERBREAD LN Owner or Tenant MATHESON WILLIAM N JR Telephone No. Owner's Address MATHESON JANICE D,28 GINGERBREAD LN,YARMOUTH PORT, MA 02675 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 bathroom. 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 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/Alertinc 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 Siens 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. ��- rY� 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: THOMAS P SULLIVAN Licensee: Thomas P Sullivan Signature LIC.NO.: 18182 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:71 WAQUOIT RD,COTUIT MA 026353517 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 1\144 (4 ttl ict -6, UC / Wilk? A e-i }il 4( I( l ri-C,1\ -_ l-o�nmorrrnsaU�s o�//la�sacffs Official Use Oil T — _ _ft �� [c7 n ?-C /11_ ' f. --ire J Permit No. — aparEmerrf v �,� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee lank) ~ �' [Rev. 1/07] � (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMIt 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (, — /O --/E City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned es notice of his or her intention to perform the electrical work described below. Location (Street&Number) 8 (3 i - 5Pr �rca d_.. Owner.or Tenant .,e y -S Telephone No. Owner's Address Is this permit in conjunction with a buidin �' g permit? Yes _ No ❑ (Check Appropriate Box) Purpose of Building " )CVe f l mL Utility Authorization No. Existing Service Amps / (f` Volts Overhead ❑ Undgrd d❑ No.of Meters . ' New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity K Location and Nature of Proposed Electrical Work: �a�, � , yvi f)el e Completion of the following table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Ceti.-Susp.(Paddle)Fans No.of Total Transformers ICVA - No.of Luminaire Outlets No.If Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ in-grad. ❑ ivo,of l.mergency Lighting rrnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons l KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local D Municipal Connection Other No.of Dryers Heating Appliances K, Security Systems:* No.of Water No.of Devices or Equivalent No.of Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP -Telecommunitations Wiring: - OTHER: No.of Devices or Equivalent � Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: /e:::1 (When required by municipal policy.) Work to Start: 6/0-7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGt;: 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 9- BOND 0 OTHER 0 (Specify:) I certify, under the pains and enalties o erj ,that information on this application is true and complete FIRM NAME: o ed C /G LIC.NO.: • License . P/ Signature (If applicable,enter"etempt"in the license mb ire.) LIC.NO.: Address: =ter--r Bns.Tel.No.: j `Per M.G.L.c. 147,s.57-61 security Alt TeL No.: work requires D artment of Public Safety"S"License: Lic.No. �c OWNER'S INSURANCE WAIVER: I am aware th 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/Agent ❑owner's agent Signature Telephone No. [PERMIT FEE: $