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Home My WebLink AboutBLDE-22-003387 o Commonwealth of Official Use Only Massachusetts Permit No. BLDE-22-003387 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:12/14/2021 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) 30 WHALE RD Owner or Tenant FORG DAVID D Telephone No. Owner's Address FORG LESLIE D, 10 TAVERN LN, LEXINGTON, MA 02421 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 ❑ 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 master bathroom. 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 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 Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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: Jonathan R Hall Licensee: Jonathan R Hall Signature LIC.NO.: 11925 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:263 CAMMETT RD, MARSTONS MILLS MA 02648 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 \-C--00Gbi 143I- RECEIVED DEC 1 4 2E Commonwealth of Massachusetts �•. Official Use Only BUj}ro„,.._m;, T Department of Fires Services Penult No(1�l-C.'S 7 By ,,�,j Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev.9105) (leave black) 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: City or Town of: yGr►ei 04.44 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) 3 d 6I1i 41. TA . Owner or Tenant l^G.S Telephone No. Owner's Address / Is this permit in conjunction th a building permit? Yes F No ❑ (Check Appropriate Box) Purpose of Building ,' Utility Authorization No. Existing Services Amps / Volts Overhead❑ Undgrd D No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ..- Location and Nature of Proposed Elecjstical Work: i AS'1'1F 12 R/04 h metp ct GA 0( § ill 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- ❑ sa iof Emergency Lighting grad. grad. ry WJaifs 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 ons 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❑Comae erica -1 Other No.of Dryers Heating Appliances KW SecurityfSjs ems or Equivalent Na.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 e Egqu Wiring: OTHER: Attached additional detail if desired,or as required by the inspector of Mires. Estimated Value of Electrical Work: '. 4 rO (When required by municipal policy.) Work to Start: 1.1 1131 a I 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 t[�7 BOND D OTHER (Specify:) I certify,under the pains and Penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jonathan Hall Electrician LIC.NO.:11925 B Licensee: Jonathan Hall Signature ��s -- LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 508-280-5113 Address: 263 Cammett Rd Marstons Mills, MA 02648 Alt.Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: 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 `i owner's agent Owner/Agent Signature Telephone No. _ PERMIT FEE:$ Email:jonc jhallelectric.com