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Home My WebLink AboutBLDE-20-000490 Commonwealth of Official Use Only 6Massachusetts BOARD Permit No. BLDE-20-000490 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:7/29/2019 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) 8 PHEASANT COVE CIR Owner or Tenant SHEMKUS JOHN J Telephone No. Owner's Address SHEMKUS FRANCES M, 128 COUNTY RD, READING, MA 01857 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: Remodel bathroom. 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 ❑ 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 perjuty,that the information on this application is true and complete. FIRM NAME: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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 P-0.00,1 -213P//' ie-- `F;p - f'2 ((? eg- o , ,q,.. _-�- Crom+nounaaCtfs 01///assac ffs ffi• Ocial Use Only 1 _. .1JaParfmani olJira Jarviud Permit No. �� ' O`t� Q BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELE RI AL WORK All work to be performed in accordance with the Massachusetts Electrical Code gv 1 Ixl(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: B City or Town of: YARMOUTH To the Inspe for of Tres: y this application the undersign • es ce of his heLintention yo, rform a ale cal work described below. Location (Street&Numbe ) GO v G Owner or Tenant ;re, 41 t( No. Owner's Address 5 GP , Is this permit in conjunctio a t du No I: (Check Appropriate Box) Purpose of Building ei 4rg ermit? YesUtility Authorization No. Existing Service Amps / Volts Overhead D. Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr E No.of Meters Number of Feeders and Ampacity i Lopationran Nature o o�pose� Work: wro t zV /�/s i - lf/Y,g!/�A (/G/ ILy� 1I� i/ 1 Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei.-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 arnd. !rod. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges 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 Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* EC No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydrornassage 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: 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 co erage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties o fPerinry,that the informationon this application is true d complete. FIRM NAMfI .tq,,#ic(,4q i• �� LIC.NO.: Licensee: /`Licensee:(If e `, Signature /LIC.NO.: e /f n licer e 1 ) �:� • Address. (/V /�„1a, c Bus.Tel.No.: /a!'�!)� j `Per M.G.L. c. 147,s.5 1,security work requires / ety Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware �tb��ensee does not have the iiabili License: insurance No. � required by law. Bymysignatureh' coverage norm below,I hereby waive this requirement I am the(check one ❑owner ❑owner's a eat I Owner/Agent Signature Telephone No. PERMIT FEE: $ s