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Home My WebLink AboutBlde-19-006766 Commonwealth of Official Use Only _, Massachusetts Permit No. BLDE-19-006766 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:5/30/2019 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) 287 CAMP ST Owner or Tenant MUIR MICHAEL J TR Telephone No. Owner's Address J&S CAPE RLTY TRUST, P 0 BOX 62,WEST BOYLSTON, MA 01583 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 LosationAn4,Nature of Proposed Electrical Work: Repair/replace wiring in bathroom&kitchen. Install new smoke detectors. 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. Batter/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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 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: 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. I PERMIT FEE: $75.00 GEC S1911 ►, �(2� ((cc c .}.... Commonwealth of///assachusal?s Official Use Only ='�{= `� �'7� Serviced Permit No. =-��_ : apar&isenf o/�irc BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ',.'-;``' [Rev. I/07] -N (leave blank) '' ' APPLICATION 'FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: `� 30 '` City or Town of: yA UTH To the Inspector of Wires. R = By this apphcation the Iindetsigned fives noti of ' r her intention to perform the electrical work described below. Location(Street&Number) !/�A Owner or Tenant MO l �� - � � Telephone No. Owner's Address , ' TZ- Is this permit in conjunction with a building permit? Yes 1----- No ❑ (Check Appropriate Box) Purpose of Building)0116,1 C J Utility Authorization No. Existing Service Amps / Volts Overhead E. Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 ti x(4k) — K.) 'k) - Nei) e- _ � '? � �v1rl�� DCompletion ofthefollowing table may be waived by the Inspector of Wires. U No.of Recessed Luminaires No. of CeiL-Snsp.(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 grad, crud 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 Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices Number No.of Waste Disposers Heat Pump 1 I J Tons KW No.of Self-Contained v Tote Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Q Connection ❑ other NkNo.of Dryers Heating Appliances KW Security—Systems:* No.of Water No. of No.of Devices or Equivalent Heaters No. of Data Wiring: QJ Suns Ballasts No.of Devices or Equivalent ` No. H dromassa a BathtubsTelecommunications Wiring: y g No.of Motors Total HP No.of Devices or Equivalent OTHER: • Attach additional detail if desired or as required by the Inspector of Wirer. r Estimated Value of Electric I Work: ?7.0 (When required by municipal policy.) Work to Start: s Inspections to be requested in accordance with MEC Rule 10,and upon completion. --....� , INSURANCE G : Unless waived by the owner,no permit for the performance of electrical work may issue unless '`s 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 E-1ND ❑ OTHER 0 (Specify:) ../) /) I certify, under the ains and penalties of perjury,that the information . applicatio is true and complete. FIRM NAME:`� ji' , ? j — • ;0,�� LIC.NO.:Licensee: �� 4, Signs, � � ��_�— (If applicable,enter "exempt"in the license m line. ' LIC.NO.: Address Bus.Tel.No.: _z/igt 4 I "Per M.G.L. c. 147, s.57-61, ecurity work requires Dep. . ent of Public Safe Alt.TeI.No.: OWNER'S INSURANCE WAIVER: I am aware that th. Licensee does not have the liability insuratnce coverage n�— S required by law. By my signature below, I hereby waive [ is requirement I am the(check one 0 owner ❑owner's a eat Owner/Agent Signature Telephone No. PERMIT FEE: $