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Home My WebLink AboutBLDE-22-004303 co Commonwealth of Official Use Only ^'f` NI Massachusetts Permit No. BLDE-22-004303 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:2/3/2022 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) 15 CAPT NICKERSON RD Owner or Tenant WILCHYNSKI MATTHEW E Telephone No. Owner's Address 15 CAPT NICKERSON RD, SOUTH YARMOUTH, MA 02664 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: First floor bath room renovations. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 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 Ballasts Data Wiring: Heaters Signs 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 perjuiy,that the information on this application is true and complete. FIRM NAME: James B Jones Licensee: James B Jones Signature LIC.NO.: 12351 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 118 MAPLE ST, HYANNIS MA 026015746 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 my signature below,I hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $75.00 ,(„644 2,13A-7,-- eg-- 01 A 3 vv Copt .e,- 4, ,uvt-p►,A) k I Eg1r)C oD j,_..J. FCEVED Recidy ' rRoc.1 A tncwic, e� r - N FEB 02 2922, Commonwealth ry�j -.__ of//la6sac lld ,._. : Official Use,Only i■ Y BUIL[11iVG u. _1,1 1!,1 c'� �/ PermitNo2-Z 36_3 T .2epartmcn,l ol..,ira Serviced Occupan r and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS I •ev. 1/07] . cave bla nk) . . : 1-7ThrZ 7--,7-R7 UT Tv FERFORtvi CLtC I RICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 7 CMR(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: v. ) l z.00 City or Town of: � n�� a By this application the undersigned gives notice of Ohis%heir in UTH cation to perform theTo I electrical ecto �Wires: Location (Street&Number) (5 work described below. Owner or Tenant VV\c.�{ lcANN",s k-, Owner's Address Scc Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No Purpose of Building re ❑ (Check Appropriate Box) Utility Authorization No. Existing Service 1CJC Amps 1-2, / 2. ,c,Wolts Overhead 2•' Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: w re., l W it P1 cr IS -'K Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 1 No.of CeiL-Susp.(Paddle)Fans No.of Total No. of Luminaire Outlets Transformers gVEs, No.of Hot Tubs Generators ECVA No.of Luminaires SwimmingPool Above in- No.of Emergency Lighttn - grnd. ❑ grad. r—i Battery Units g No. of Receptacle Outlets No.of Ott Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges Na. of Air Coad Total _ Togs No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained l7 Totals: Detection/Alerting Devices v No.of Dishwashers Space/Area Heating KW or Li❑ Muaicipa[ Connection ❑ other No.of Dryers Heating Appliances KW 5ecurtty Systems:* 3 No.of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent �"' No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent 1, Attach additional detail if desired or as required by the Inspector ofWires. U Estimated Value of lee -cal Work ��(� 4 Work to Start: (When required by municipal policy.) -2- 2 ZZ Inspections to be requested in accordance with MEC Rule 10,and upon completion. ---t ,, INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless I) the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The I1 undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 7 BOND l�.� I certify under th ❑ OTHER ❑ (Specify:) / i adpen s of pg✓jury,that the information on this application is true and complete -b/ FIRM NAME: J G Licensee: ",,�� meS LIC.NO.: 1S{ 6 `rG'.v-S Signature 7 „, �— (Ifapplicable,enter ept in the cerisemb ine.) LIC.NO.: Addresr. ycic„1Si.,vq‘c.�1. S Bus.Tel.No.: S� 3 a J "Per M.G.L. c 147 s 57 61,security work requires Department of Public SafetyAlt Tel No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not havethe liability insurance coverage n '- S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ❑owner's a eat_ T Owner/Agent Signature ' Telephone No. PERMIT FEE: $ 'J,.i