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Home My WebLink AboutBLDE-19-001965 , PY1//> Commonwealth of Official Use Only itlitkcif Massachusetts Permit No. BLDE-19-001965 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:10/2/2018 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 electncal�described belo Location(Street&Number) 70 OLD MAIN ST I (� CD � NM C-A.,I._-. Owner or Tenant KENNEDY ANN ELIZABETH EST OF Telephone No. Owner's Address C/O TD BANKNORTH NA TR,90 PEARSON BLVD AT:CHARTKOWSKI,GARDNER, MA 01440 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: Kitchen remodel 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 0 (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 0 owner's agent. Owner/Agent Signature TelephoneTelephone No. PERMIT FEE:$75.00 tub' t o(c(fe Ke, J l ommoruveaGth al 1/(404c4144shb Official Use Only l/l/Only Pr' �� • $" c� c7 [� Permit No. ct tt 2tm sparend o/_}ua Jervlce3 �i; � Occupancy and Fee Checked ' BOARD OF FIRE PREVENTION REGULATIONS Rev. f ( ._� !/ 1/07] leave blank) 1Ft ;; APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 2 All work to be performed in accordance with the Massachusetts Electrical Code( EC) 52' 12.00 4 f i (PLEASE PRINT IN INK OR TYPE ALL INFO TION) Date: /0 a I k ' theIn ect r ofWires: ; f , City or Town of: !' �}�f�'f UU—�� To ' i By this application the undersigne gives notice of his or her intenti n to perform the electrical work described below. ' ':-''Z. . Location(Street&Number) 7O M ) c "- Owner or Tenant 'j 1, �p Telephone No. ..,_....,.- _ _... Owner's Address SAY I-2--- _ Is this permit in conjunctio with a buildin�j permit? Yes No (Check Appropriate Box) , Purpose of Building / +Ayy,,1 nv U S�� Utiii Authorization No. ExistingService OD Amps iio l olt0Volts Overhead Undgrd C No.of Meters J P New Service Amps / Volts Overhead E Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ) 1i M i. C 1A,7 6- />,� lee.* Q ,clams. Sett/6— Completion of the.followinp table may be waived by the Inspector of Wires. Total No.of Recessed Luminaires No.of Ceil.-Su Tr KVA sp.(Paddle)Fans of Transformers No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting g and. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners go.I Detectionng and Inn itiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons -kW No.of Self-Contained p° Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Connection Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KWNo.of No.o1 Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Aydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desire.d,or as required by the Inspector of Wires. Estimated Value of le trio Work: I 'i� (When required by municipal policy.) Work to Start: (D///l) 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' surance including"completed operation"coverage or its substantial equivalent, The undersigned certifies that such coy-'age is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L BOND 0 OTHER 0 (Specify:) I cern:fy,under the pains aftd penaltiesA0erjury,that the information on this application is true and complete. � ) ) FIRM NAME: 4 C n ) Gr^, LIC.NO.: /V' � T, / i Licensee: J &Ck Girt c Signature LIC.NO.: E 7/9 (If applicable,ent tempt"in the license min#1r line.) Bus.Tel.No.: 923-V??-0/5—el' Address: 071, DYL 50.1/`j yiLeivoA da 44 y Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requirks Department of Pubh Safety"S"License: Lie.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)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$