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Home My WebLink AboutBLDE-21-005166 �� J1/ Commonwealth of Massachusetts Official Use Only Permit No. BLDE-21-005166 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•3/11/2021 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) 12 JONQUIL RD Owner or Tenant Dennis Nagel Telephone No. Owner's Address 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 new 1/2 bathroom. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 3 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 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 No.of Gas Burners No.of Detection and Initiatinc 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/Alertine 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 Siens 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 L Donohue Licensee: Thomas L Donohue Signature LIC.NO.: 32679 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:21 WOODRIDGE RD, E SANDWICH MA 025371715 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 26-‘3-ett6( (f7..4Z-i (t (/?7 � / � yy I 14,1 COMMORW414114 4//jassa ,w.th //��O--fficial Use Only Permit No. IV .2eparbrheat 4 Serviced Occupancy and Fee Checked ` \, J BOARD OF FIRE PREVENTION REGULATIONS [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 C (PLEASE PRINT IN INK OR PE ALL INFORMATION) Date: Men n 2 9 o)e ui 1 City or Town of: YIi 0100 7A 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) /i /. • 7 VO / i Po k3Owneror Tenant ON);S /V / /1//9/3 6::/.—. Telephone No. sos7 (,5// t;04 cf Owner's Address seine �.1 Is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. C Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters t-,\ LitnIcakI Amps / Volts Overhead 0 Undgrd 0 No.of Meters -----6-) Number of Feeders and Ampadty Location and Nature of Proposed Electrical Work: 11/ke 46,,,e I' 4j 4/f 137i vi Completion of thefollowingtable me be waived by the Inspector of Wires. No. l� No.of Recessed Luminaires 3 No.of CBL-Snap.(Paddle)Fens Transformers TKVA C1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA ck Above In- No.of Emergency Lighting Na of Luminaires Swimming Pool fid. ❑ gird. ❑ Battery Units .1 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners )N°'ifDetectiongDevices 1;t No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Rea Toottals:mp Number Tons KW _��n/Self-Contained in No.of Dishwashers Space/Area Heating KW Local 0 Connectionevices 0 Other Na of Dryers Heating Appliances KW Security t No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent • No.H Bathtubs No.of Motors Total HP TelecommunicationsNofDeviceor N Hydromassage Na of Devices or Ent t OTHER: y,) Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: /o v (When required by municipal policy.) Work to Start:Mn if O J 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 0 BOND 0 OTHER 0 (Specify:) I cote,under tire pains and penalties of perjury,that the information on this application is true and completes FIRM NAME: A LIC.NO.: Licensee: 7/30 0)A S Do. Ao c• SignatureJ`"1LIC.NO.: 3 6 79 r (if applicable.eifer"exempts'ii}the/ numbir 1 ) / / Bus.TeL No.: 50e 174 4,f C1 S— Address: .1/ l le7.., i;G a ./L' S.A/1C�ifi.G/t U Alt.TeL No.: 'Per M.G.L.c. 147,s.57-61,security work requires 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 low,I heiVy waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agentn Signature 1 ,fih'y 44---Telephone No.CO ,S6/ 6o 0 I PERMIT FEE:$ 7S