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Home My WebLink AboutBLDE-22-004971 or Commonwealth of Official Use Only Ems,� Massachusetts Permit No. BLDE-22-004971 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:3/8/2022 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) 18 LYNDALE RD Owner or Tenant EGAN JAMES M Telephone N Owner's Address EGAN TINA, 78 HUNT DR, STOUGHTON, MA 02072 �' F Is this permit in conjunction with a building permit? Yes CI No 0 brji Ail oprte Bode Purpose of Building +^� Utility Authorization No. ;�i_.'°' Existing Service Amps Volts Overhead ❑ Undgrd 0 M`et s , ',' New Service Amps Volts Overhead 0 Undgrd 0 Noletfeps Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for addition(Bedroom&2 baths) w ,,,,, 1 ,,,, Completion of the following table may 6/25by the nspector 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 Aboved. ❑ g rnd. ❑ No.of Emergency Lighting rn Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I 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 Ton No.of Waste Disposers Heat Pump I Number I Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Eauivalent 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: OTHER: No.of Devices or Equivalent 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 ❑ OTHER 0 S eci I certify,under the pains andpenalties o (Specify:) f perjury,that the information on this application is true and complete. FIRM NAME: Jack W Griffin Licensee: Jack W Griffin Signature LIC(If applicable,enter"exempt"in the license number line.) Tel. NO.: 418 Address:26 JOANNA DR, S YARMOUTH MA 026641339 Bus.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.Tel.No.: 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)) ❑ owner ❑ owner's agent.Owner/Agent Signature Telephone No. I PERMIT FEE:$75.00 I RECEIVED _..: MAR 0 8 2022Co saith�r//aasaci(iwelie official use only D I N U D c HART NI '' at enure Jirvu ed Permit No.-_�7'---2_ � - - " ' 'REVeNTION REGULATIONS Occupancy and Fee Checked APPLICATIONtR�. 1/07] weave blank) -' FOR PERMIT TO PERFORM ELECTRICAL WORK L' ! 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) City or Town of: Date: f � t. Sy this application the undersigned gives his Hention to perform the electrical work To the I ector of r • Location(Street&Number) ,V described below..: /k AV NJ - owner or Tenant J`y,y., N L /7l\J Owner's Address Telephone No. Is this permit in conjunction with a buildingpermit? �` purpose of Building Yes No E] (Check Appropriate Box) �` Utility Authorization No. !listing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters tiggfigake Amps / Volts Overhead 0 Undgrd Dumber of Feeders and Ampadty g ❑ No.of Meters t Location and Nat1ttre of Proposed Electrical Work: �` YIA Co ,letfon o the ollowin_ table m, be waived. Q No.of Recessed Luminaires No.of Ceil.-Sn `o.o the In for o Wires. all.(Paddle)Fans Transformers ota V No.of Luminah a Outlets Na of Hot Tubs ''+ 4 Na of Luminaires Generators KVA Swimming Pool d.e ❑ n- 'o.oe 'mergency r " No.of Receptacle Outlets d• ❑ Batte Units ? ng �: No.of Oil Burners No.of Switches No.of Zones No.of Gas_Burners 'a o r • ,n a, , i 2.r Initiatin Devices e. No.of Air Cond. ° Tons No.of Alerting Devices a of Waste Dbposer s 'eatmp um i er one 'o.o on n a , No.of DishwashersTotals: - mum Detection/Alertin Devices Space/Area Heating KW Local❑ v WI Inn Na of Dryers Heating Appliances . . Connection ❑ Otbet• '.o.o " r KW y Heaters KW o.o 'o,o No.of Devices or E i uivalent S i s Ballasts Data Wiring: Na of Devices or ' ,nivalent No.Aydromassage Bathtubs No.of Motors Total HP e ecomma i ; i ns } r^ g OTHER: Na of Devices or ' ,uivalent Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: m Work to Stag: ��' Inspections--- en required by municipal policy.) $URANCE to be requested in accordance with MEC Rule 10,and upon completion. RAGE: Unless waived by the owner,no penult for the performance of electrical work may issue unless the',licensee provides proof of liabilityinsurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the CHECK ONE: INSURANCE BOND ❑ OTHER 0 (S permit issuing office. I certify,under the (Specify:) pains and penalties o, rJury,that the Information on this application is true and complete. FIRM NAME: , r1<-)[c�. .//?",. ",.�1 Licensee: „,A'-_, (". LIC.NO.: �� •„( _ Ucenie(ifapplicoble, ter t - ' Signature ' in the license nwn�er•li e.) --� LIC.NO•f_ Address: j! :' Bus.TeL No.. i•-' .'=< . "Per M.G.L.c. 147,s.57-61,security workJ t /A O OWNER'S INSURANCErequires De ent of Pub rc Safety"S"License: Air'TeL N . WAIVER: I am aware that a Licensee does not have the liability insurance coverage normally requiredrequired by law. By my signature below,I hereby waive this requirement. I am the(check one I♦ owner ■ owner's avant. Owner/Agent Signature Telephone No. PERMIT FEE:$