The URL can be used to link to this page

Home My WebLink AboutBLDE-19-004221 Commonwealth of Official Use Only �. , 4t41. 9\1:.5 Massachusetts Permit No. BLDE-19-004221 yie39BOARD 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:1/22/2019 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 descri ed elow. Location(Street&Number) 11 CAROL RD ' (/f1 ` Owner or Tenant GURSHA JAMES P Telephone No. Owner's Address C/O FARRAR CODY J, 515 EAST HARTFORD AVE, UXBRIDGE, MA 01569 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 for 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 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR,S YARMOUTH MA 026641339 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 ❑ owner's agent. Owner/Agent Signature Telephone Telephone No. PERMIT FEE:$75.00 at Z3l(l Il: A ( fi/23/I e1 ' \ ''\( li Commonwealth of Massac tts , Official Use Only Co 1/1 :_ Z. ==�0 - eparfmcnf o f. ire Permit No. • cervices BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �St 1 1 ev. l/07) (leave blank) 'I 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: /// /9 City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the undersigned gives notice 9f his or her intention to perform the electrical work described below. Location(Street&Number) // (2Alec) I Rb Owner or Tenant Rif ptrrJ /v)pot c_e J 1 o 1 Telephone No. Owner's Address y6? 61?k. 5-4- Sh rt,w5 bu(Li M)1 OI 5-(45- Is this permit in conjunctio%with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building / y'lni 1 hov y(f U ' uthorizatlon No. Existing Service /'00 Amps /'/a'(0 Volts Overhead Undgrd l;r ❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd>;t' ❑ No.of Meters _- ,w _ Number of Feeders and Ampacity tom.p) ,_Location and Nature of Proposed Electrical Work: J ��jQ ) " q N ' Completion of the followta sable may be waived the Ins -.�� r�, o.of Recessed Luminaires No.of �' pertor of Fires. No.of Cell-Sup.(Paddle)Fans Total 4;. Transformers KVA o. of Lumiaasre Outlets No. of Hot Tubs - - Generators KVA o.of Luminaires Swimming Pool Above ❑ In_ No.of�;mergency Lighting - .!; rrnd. �d ❑ Battery Units w o.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones 4 _po.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total , Tons No.of Alerting Devices 1No.of Waste Disposers I Heat Pump Number Tons �KW No.of Self-Contained " Totals:I Detection/Alerting Devices No.of Dishwashers 5pacefArea Heating KW Local❑ Municipal J Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent . v Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent V No.Hydromassage Bathtubs No.of Motors Total HP - Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired Estimated Value of Electrical Work or as required by the Inspector of Wires.(Whunicipal policy.) Work to Start: g Inspections to be requested in en accordrequireancedby wmith MEC Rule 10,and upon completion. INSURANCE 0 RAGE: 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 cove a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND 0 OTHER I certify, under the pains and penalties o 0 (Specify:) FIRM NAME: f trt ry,that the information on this application is true and complete 0 GG G2! ry d Licensee: 7Il Gk, G'f 1 )v...) LIC.NO.: /� y J {� (If applicable.excel Signature LIC.NO. S- Address: (� Pt"in the license number�e.) Jo J Bus.Tel.No.: -s'd/ J Per M.G.L. c. 147,S.57-61,security work requires Depent of Public Safety11 Alt.Tel.No.- OWNER'S INSURANCE WAIVER: I "S"License: Lic.No. am aware that the Licensee does not have the liability insurance coverage n rm� required by law. By my signature below,I hereby waive this requirement. I am the(check one Owner/Agent 0 owner ❑owner's a ent ISignature Telephone No. .• PERMIT FEE: $