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Home My WebLink AboutE-20-1287 Commonwealth of Official Use Only E144\ . Massachusetts Permit No. BLDE-20-001287 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:9/9/2019 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) 29 BRAY FARM RD NORTH Owner or Tenant CURLEY ELIZABETH A Telephone No. _ Owner's Address 29 BRAY FARM RD N,YARMOUTH PORT, MA 02675-1551 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 CI No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Complete 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 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. PERMIT FEE:$75.00 Zctjcac ll(o((`t M._ Pcm6c, 64tss-tiv-G F-ocroats t A/ IdAmnixot \ off« R Commonwealth of//laact!uissffs Official Use Only a r ,. .., ccam�,, cc�� n I ,t rL = ..UaparE,nret f}ir•J Permit No.• (JLc — Z_��P 3' i O Services °,; •!1 = BOARD OF FIRE PREVENTION REGULATIONS [Rev . ]cy.a(l Fee Checked 1 Ill :' _,s (leave blank) • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK i 0 All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 d LL1 , !(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: + _ City or Town of: y OUTH `—""'" �""'""'"""':'�t By this application theTo the Inspector of Wires_ [mb ed • notice ofor her intention to perform the electrical work described below. 1 Location(Street&Number) )5 7r ,G `✓ N.�� Owner'or Tenant ,4x1J f . 9 Telephone No. Owner's Address Is this permit in conjunction with a baildipg permit? Yes L No ❑ (Check Appropriate Bar) Purpose of Building R..c$ 1 e CYL 3 I at. I` Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und grd❑ No.of Meters New Service Amps / Volts Overhead❑ Undg rd ❑ No.of Meters Number of Feeders and Ampacity N. Location and Nature of Proposed Electrical Work: Ce, u i,,,4 j. Re Oc . 61 Lf 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 -4 No.of Luminaire Outlets No. of Hot Tubs Generators KVA No.of LuminairesSwimming pool Above in_ No,o11".mergency Lighting �/ Prnd. grid. 0 Battery Units -S1., No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones V No.of Switches No.of Gas Burners 'No.of Detection and Initiating Devices No.of Ranges Na of Air Cond. Total 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 Loral D Mupal _ Connectionicin ❑ O(iner No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromass age Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail ff desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: j�� (When required by municipal policy.) Work to Start 4,—9—/9' 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ND 0 OTHER 0 e y,that (S i ) I certify, under the pains and p fp � i the info 0 on Der ' phi • n is true and complet FIRM NAME: / > LIC.NO.: /O� Licensee: S' (If applicable,a ter"exempt"in the license Sign r LIC.NO.: Address-. Bus.Tel.No.: �� J Per M.G.L. c. 47,s.57-61 securitywork requires Department of Public Safety _ Alt.Tel.No.. - OWNER'S INSURANCE AMER: 1 am aware that the Licensee does not havethe liabilityLin.No..---________ required by law. By my signature insurance coverage n S Owner/Agent by la below,I hereby waive this requirement. I am the(check one owner ❑owner's a enL 1I Telephone No. PERMIT FEE: $