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Home My WebLink AboutBlde-19-001138 • Official Use Only V Commonwealth of i �fL Massachusetts Permit No. BLDE-19-001138 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:8/24/2018 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) 51 HOLLY LN Owner or Tenant MCCORMACK EDWARD M Telephone No. Owner's Address MCCORMACK NORMA M, 11 GREATON RD,WEST ROXBURY, MA 02132 Is this permit in conjunction with a building permit? Yes 0 No 0 eck Appropriate Box) Purpose of Building Utility Authorizatio' o' Existing Service Amps Volts Overhead 0 Undg eters lir New Service Amps Volts Overhead 0 Un': y ` 47 Number of Feeders and Ampacitya):).0 !( Location n N r and Nature of Proposed Electrical Work: Remodel kitchen&bath room. O Completion of the following table " e Inspector of Wires. No.of Recessed Luminaires 12 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 14 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 7 No.of Gas Burners No.of Detection and ^ Initiating Devices J\ 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 1 Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent q No.of Water KW No.of No.of Data Wiring: I(v Heaters Siens Ballasts No.of Devices or Equivalent \vim 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 ❑ BOND ❑ 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 A WILLMAN Licensee: Timothy A Willman Signature LIC.NO.: 17476 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 STURGIS LN, BARNSTABLE MA 026301419 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 .. q"----k . _ aPinmoruusa[tk off///a36ach..43a(f6 'cia UUse On . ' c�77 n Permit No. N \ aI-- ,* spari.nant ol.}irs Jseviced 1 - r ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ZRev. 1/07) (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C . (MEC),527 12 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .1 - 2- 1 S City or Town of: YARMOUTH To the Inspect.. of Wires: By this application the pndersigned gives n •ce o his o her intention to perform the electrical work described below. Location(Street&N tuber) S 1l I Owner or Tenant G Telephone No. Owner's Address v _ (Q(2t be (.1111111 1 ` Is this permit in conj •on with a'15'ililding permit? Yes Q"'� No ❑ (Check Appropriate Box) Purpose of Building `�,_� _, Utility Authorization No. Existing Service teICIAmps kfQ/ et14010 Volts Overhead pndgrd❑ No.of Meters H ew Service wAmps / Volts Overhead❑ Undgrd 0 No.of Meters W>\ `umber of Feeders and Ampacity cq,..A....\.N 9a lion and Nature of Proposed Electrical Work; r f 311 ..._\ w .� II W Completion of the followin table may be waived by the Inspector of Wirer. V V I,z o.of Recessed Luminaires t No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers I{VA (�j � n.of Lnminaire Outlets No.of Hot Tubs Generators KVA a l s,of Luminaires Swimming Pool Above ❑ In- No.of 1!mergency Lighting -- grad.. grad. ❑ Battery Units No.of Receptacle Outlets t 4 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches .. No.of Gas Burners No.of Detection and �'►- w Initiating Devices No.of Ranges ` . � No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number!Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers t Space/Area HeatingKW' Municipal LOB Connection other No.of Dryers C:24 Heating Appliances KWSecurity 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 Telecommunications Wiring: - No.of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of lee ' a1 Work: (When required by municipal policy.) Work to Start: S f 6 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: 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 covers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE .0-BOND 0 OTHER ❑ (Specify:) I certify, under the p ' and pe p • that the information on this ap lication is true and complete. FIRM NAME: (, LIC.NO.:1 Licensee:,( Signature x LIC.NO.: (If applicable, nter"ea in t Ilk a number!fir Bus.Tel.No.-Address Alt.Tel.No.: •••I "Per M.G.L. c. 147,s.57-61, curity work requires epartment of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE W IVER: I am aware that the Licensee doer not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. i Owner/Agent I PERMIT FEE: $ '7SfI Signature Telephone No.