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HomeMy WebLinkAboutBlde-19-001436 co Commonwealth of Official Use Only filqi Massachusetts Permit No. BLDE-19-001436 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:9/11/2018 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 electrical work described below. Location(Street&Number) 55 HIGHLAND ST Owner or Tenant JOYCE THOMAS Telephone No. Owner's Address JOYCE BARBARA,63 ORIOLE STREET,WEST ROXBURY, MA 02132 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appr • x) / Purpose of Building Utility Authorization No. I©/O Existing Service Amps Volts Overhead 0 Undgrd 0 ..... . O New Service Amps Volts Overhead 0 Undgrd 0 No i • s I//1A`71111fr Number of Feeders and Ampacity • s or', Location and Nature of Proposed Electrical Work: Kitchen remodel. O O 1 Completion of the following table may be waived by t .t Wires. No.of Recessed Luminaires 10 No.of Ceil:Susp.(Paddle)Fans No.of Transformers K No.of Luminaire Outlets 12 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- CINo.of Emergency Lighting :Par! grnd. Battery Units No.of Receptacle Outlets 14 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 16 No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges 1 No.of Air Cond. 1 Total 2 No.of Alerting Devices _ Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained 4 Totals: Detection/Alertine Devices .No.of Dishwashers 1 Space/Area Heating KW Local 0 Municipal 0 Other: Connection No.of Dryers 1 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. CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) (� �'I / ' I certify,under the pains and penalties of perjury,that the information on this application is true and complete. L.-0 V FIRM NAME: Brian Mcgrath Licensee: Brian Mcgrath Signature LIC.NO.: 11807 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 TURTLE COVE RO, EAST SANDWICH MA 025371710 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 n ( i e4r) L lLE f tat L(CW-T- - 4/r Weis (4/,4 ?(17/fe g V C.onrnwonwea�of Maaaac O icia Use Only ��-x —' c� c/ Permit No. q (L( 3 4: ,1�-a �� _�•._ 7i.pariment o`_tira�ervic. " _ -1= y Occupancy and Fee Checked ''r, ..r�,4� BOARD OF FIRE PREVENTION REGULATIONS [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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YQY� u ,Lz To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) 5jc h yA /4 / 7f J _c1.a caner or Tenant "G,� ��L- )j // Telephone No. z � 1)j111 owner's Address d../ w - . this permit in conjunction with a buildi permit? Yes o El (Check Appropriate Box) .�, urpose of Building Utility Authorization No. [ 14= xisting Service Amps / Volts Overhead n Undgrd n No.of Meters f 0 `'z l ew Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters � — " ;:-.E , umber of Feeders and Ampacity .",I:.t. __. r_ > ocation and Nature of Proposed Electrical Work: / -7 e 4 r�jn of i / Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans r Transformers KVA No. f VA No.of Luminaire Outlets — No.of Hot Tubs .i Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting /a grnd. grnd. Battery Units No.of Receptacle Outlets l y 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. / Tons No.of Alerting Devices No.of Waste Disposers _ Heat Pump Number Tons I No.of Self-Contained t/ Totals: Detection/Alerting Devices 7 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 KWNo.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 E ctr' al Work: /99, 0.0 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C E E: 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 [BOND ❑ OTHER ❑ (Specify:) I certify,under the pains d penalties of perjury,that the information on this application is true and complete FIRM NAME: /Ji4 "hi jrci/ Flcr F/,C 1L/( LIC.NO.: t/`(77 tJ Licensee: li Signature /�J LIC.NO.: (If applicable.enter "exempt"in the license number line.) c-� Bus.Tel.No.: J y t'v ^�Zl Address: Alt.Tel.No.: *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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $