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Home My WebLink AboutBLDE-23-000517 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-000517 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:8/2/2022 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) 12 SUFFOLK AVE Owner or Tenant WARNER GEORGE H II Telephone No. Owner's Address WARNER HEATHER S, 12 SUFFOLK AVE,WEST YARMOUTH, MA 02673 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: Replacement fan/light • 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ti 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW 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: IAN B JACKSON Licensee: Ian B Jackson Signature LIC.NO.: 39860 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:273 MAIN ST, HARWICH MA 026452467 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 gc,04/K /-1 wv -' & , ltp, 114 Commoniveaa el e ///adeac1 aerlla Official Use Only 7 Permit No. 2i3 ---0Si 1 BOARD OF FIRE PREVENTION REGULATIONS 'p8ncy and Fee Checked _. 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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: g : ( r 2 Z_ City or Town of: _YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ofhis or her intention to Location(Street&Number) k S U perform the electrical work described below. a \� A� SST yo,-�,- M Owner or Tenant CepO C� W 0 Owner's Address Telephone No.Sag-21 7-440D4 tom- S�•.Kok L Ao 4, Is this permit in conjunction with a building permit? Yes Purpose0 No pi (Check Appropriate Box) of Building `otcJec..i..411 c Utility Authorization No. Existing Service l-o p Amps /Lo /2yo Volts Overhead T J Uud rd g 0 No.of Meters New Service Amps / Volts Overhead 0 Undgrd Number of Feeders and Ampaudty 0 No.of Meters Location and Nature of Proposed Electrical Work: yy-- n f^:2ST f IPo.2 b {Zp007' /j1sC I?Gcc_, f ,6a14 An w f'Gli LT Completion of thefollowingtable may be waived by the/ for of Wires. I No.of Recessed Luminaires No.of Cell.-Snsp,(Paddle)Fans n No.of Luminah e OutletsTransformers KVA No.of Hot Tubs Generators KVA No.of Laminaires Swimming Pool Above 0In- ❑ Iva of Emergency Lighting ' ` No.ofd. BAtte Units Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones '4 No.of Switches No.of Gas Burners No.of Detection and t t r No.of Ranges Initiating Devices 4. No.o Mr Cond. Total No.of Alerting Devices Tons 'amp 'nun,. r Boas ' " `o. , Vas on r n Na of Waste Disposers 'Totals: """ �''' Detection/ No.of Dishwashers � � � Devices Space/Area Heating KW Local❑ 'un i�'t No.of Dryers He A Connecfion ❑ Other g PPliances , a o.o No.of Device;or nivalent o.o Heavers H<V o s Boallaats Data Wiring: No.Hydroaiassage Bathtubs No.of Devi or trivalent No.of Motors Total HP a main a g OTHER: No.of Devices or trivalent Attach additional detail Ifdesired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �D�' Work to Start: �f,z� (Whenrequired by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and INSURANCE COVERAGE: Unless waived by the owner,no upon completion the licensee provides proof of liability permit for the performance of electrical work may issue unless the licensee fies that such coverage insurance including"completed operation"coverage or its substantial equivalent. The CHECK ONE: INSURANCE 0 BOND D force,and has ( p exhibited proof of same to the permit issuing office. J ter*,under the pains and 0 OTHER 0 (gpceify,;) FIRM NAME: petrakles ofperjury,that the information on this application is true and complete. Lfcenaee: gn Tti Signature LIC.NO.: (If applicable.enter exempt in the icense number line.) LIC.NO..`� *Per M.G.L.c. 147,s.57-61,el r t O,�m�E$- Bus.TeL No.: �e6Q security work requires Department of Public SafetyAlt TeL No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not avesthe liability insurance coverage normally— required by law. Bymysignaturense: Lic.No. la below,I hereby waive this requirement. I am the(check one8 'sa:a owner ■ owner's a:ant. Telephone No. PERMIT FEE:S