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Home My WebLink AboutBLDE-22-007018 Commonwealth of Official Use Only +? 1 A\ Massachusetts Permit No. BLDE-22-007018 >/ 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:6/6/2022 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) 10 LOOKOUT RD Owner or Tenant JARVIS MICHAEL Telephone No. Owner's Address JARVIS LINDA, 110 CLUBHOUSE LN, NORTHBRIDGE, MA 01534 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 kitchen,wiring for room above garage, &upgrade service. 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. rnd• 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal p Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water Kati' No.of No.of Ballasts Data Wiring: Heaters Siens 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: Licensee: Joshua Jones Signature LIC.NO.: 23155 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 Pine Tree Circle,7 Liefs Lane,Sandwich MA 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. PERMIT FEE: $75.00 oil, 7 S/ 61•)-A- It(r1v4 �- E C E I V tO ,wwoa 01 ma c Official Use Only is-`-— 6 Permit No. t'y21--1 o( 6 ='�`--w JUN 03 2022 nrgn,,.sawiCaf E Occupancy and Fee Checked __1'-..-. _ BOARD OF IR PREVENTION REGULATIONS IRev. 1/07] eav •Y''�t: ILDING DEPARTMENT (l e blank) " '": ' a R PERMIT TO PERFORM ELECTRICAL WORK tAll work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 612�22 City or Town of: `lct✓v-ioortt To the Inspector of Wires: By this application the undersigned gives notice of his or/her intention to perform the electrical work described below. (N\ Location(Street&Number) 10 L aakcu 1- ✓M. Owner or Tenant j t i 64 a v j J 44.'3 Telephone No. ,ram 277-CYC( 4- Owner's Address 10 Lcc,ka.4- ✓i s Is this permit in conjunction with a building permit? Yes Er No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /CO Amps 12.c / 2(IC Volts Overhead Er Undgrd❑ No.of Meters 1 New Service 9..cie2 Amps 11G / 7`lt Volts Overhead Er- Undgrd ❑ No.of Meters Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work:� wl/I 14,,}c AS yzej/, / L✓ail'11n f�4:,A tito,,vtt q a✓,iQ,,_ �iS Atede f� (.. 4-14Xv.' c -/vr7.� �j (J �(JomplettnA of the followingtable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool 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 Detection and No.of Switches No.of Gas Burners Initiating 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 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SceNo.uritof Devices or Equivalent No.of Water ..No.of No.of Data Wiring: Heaters KW 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 Electri Work: t '_G00 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabilityinsurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge 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 of perjury,that the information on this application is true and complete FIRM NAME: ,✓e' tiL✓ G 'IL- Ci LIC.NO.: 23155-A Licensee: -,lost, --:,:cc,,.t> Signature ...----3.---- LIC.NO.: 3-319M (If applicable, enter `gtempt"in the license number line.) Bus.Tel.No.: s- -77 cfC( Address: 1 ,w,_ fides Gticle.- Sfrnv(..-i c.LI l ,t!',� 0),6 6)) 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 below,I hereby waive this requirement I am the(check one)❑owner ❑owner's agent Owner/Agent Signature Telephone No. PERMIT FEE: $ T 'i1,