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Home My WebLink AboutBlde-20-000782 Commonwealth of Official Use Only Permit No. BLDE-20-000782 Massachusetts 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:8/12/2019 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) 79 NAUTICAL LN Owner or Tenant !. ,av F' ',,.^24 ,,1",J TRS Telephone No. Owner's Address x ' 79 NAUTICAL LN, SOUTH YARMOUTH, MA 02664-1618 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 ❑ 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: Replace 18 trims, 3 track lights,5 dimmers,and make corrections to sub panel. 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 0 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 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: IAN B JACKSON Licensee: Ian B Jackson Signature LIC.NO.: 39860 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:273 MAIN ST, HARWICH MA 026452467 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 No. PERMIT FEE:$50.00 9C 6A-6P t n - Ldo me-- s i ,0-4) /36' eINAI€ — tQR oft er,, c r dtfht csr-t-1-02;...) 8_131(aLE- RECEIVED AUG 12 Z019 _ /� BUi•-- �[�11F PAR TMENT COmrnonw1021th a addac ie-_ -I1 /// ffs • Ay -ccalU�Ch,ly _-,�1__i cc'�� cc-7� n L_ _ -.is,-- = 2leparlment o/?ire Serviced Permit No. • - -= REGULATIONS' BOARD OF FIRE PREVENTION REGUL Occupancy and Fee Checked ':'�'`• ,[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: L ‘,6: G. City or Town of: YARMOUTH °l To the Inspector of Wires: 4 By this application the Emdetsigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 1 q •Avg ICht_ Lan c Owner or Tenant 9?P40'JA2.A aoiDP aeACck Telephone No. N Owner's Address IQ (F Is this permit in conjunction with a building permit? Yes ❑ No V (Check Appropriate Box) Purpose of Building �44,)ewi,,LS Utility Authorization No. 1 Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters N Number of Feeders and Ampacity (II`, Location and Nature of Proposed Electrical Work: 1 et Nt p c_p A tf r� 4rc Ls E fir, D ��.�vr.�-�..rr /1L�!✓I C 1� �fn�r � �'L�� t �� f�-�C Completion of the followin&iable may be waived by the Inspector of Wires. Q No.of Recessed Luminaires No.of Cei1.-Susp.(Paddle)Fans No.of Total Transformers KVA 0 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ 'No.of lmecgency Lighting =and• :and. Battery Units i - No.of Receptacle Outlets No.of OilBurners FIRE ALARMS jNo.of Zones o No.of Switches No,of Gas Burners No•of Detection and No.of Ranges Total Initiating Devices No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal ' Local❑Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters ' 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 desires{ or as required by the Inspector of Wires. Estimated Value of Electrical Work: 3pco (When required by municipal policy.) Work to Start: e\ t let, Inspections 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 covra.ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I cernr, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: `' ....,ek". "i"' ---�— --14•so.v Signature _ LIC.NO.: Ir 33. �� (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.Address: J `Per M.G.L. c. 147,s.57-61,securi work re Alt Tel.No.: ty quires 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 \I Signature Telephone No. I PERMIT FEE: .S' 1 i