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HomeMy WebLinkAboutBLDE-22-007398 Commonwealth of Official Use Only fL ,,. Massachusetts Permit No. BLDE-22-007398 BOAR r 0 F FIRE PREVENTION REGULATIONS Occupancy and Fee Checked .,;, ti� [Rev.1/07] 11 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:6/24/2022 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) 4 MELVA ST Owner or Tenant Camilla Flannery Telephone No. Owner's Address MA 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: Split system, receptacle under sink, &relocate wires in stairwell. 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- ElNo,of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 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. 1 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 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 ofperjury,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: $50.00 r= ‘) (c-tC(3 C(X3/73 rE,, (2tAd '( 7f3 �)A qt42_5 1 RECEIVED [juN 23622, (�onensonsvea�of aeeachiuest*le Official Use Only " th •+ �.. �, Se Permit No. z—7 579 BUILDING 1 N T sParfnunE el s�v ervical B y -_ --,• i Y Occupancy and Fee Checked \_,,,! = *ARC OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 11) All work to be performed in accordance with the Massachusetts Electrical Code(M ), 27 12.o0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 2,3 �a City or Town of: YARMOUTH To the Inspect° of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Li Met fro 3 ' Owner or Tenant C�WIi l(a Owner's Address G mac`) Telephone No. 67/7-6,tl 7— I6 7 • Is this permit in conjunction with a building permit? ? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Q^5 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters © New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: I t� yvvi tt Spig . ap(p, ova 0- LAP/, 4,5, Siv, 1C$ Ma? Cvc?C3 XIN re S i i� Completion of thefollowinttable may be waived by the Inspector of Wires.tit. No.of Recessed Luminaires No.of Cell.-Sasp.(Paddle)Fans No.of otal . Transformers KVA n No.of Luminaire Outlets No.of Hot Tubs Generators KVA k No.of Luminaires • Swimming pal Above In- No.of Emergency Lighting grad. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones -No.of'etectlon and No.of Switches No.of Gas Burners Initiating Devices I V No.of Ranges No.Si Air Cond. T 1 ons No.of Alerting Devices No.of Waste Disposers Heat Pump I Dumber Tons KW No.of Self-Contained Totals:l - "F " """....•-- Detection/Aiertin Devices No.of Dishwashers Space/Area Heating KW Local Municip ❑ Connection ❑ ' No.of Dryers Heating Appliances KW Security Systems:* No.of Water , No.of No.of Data Wirinevices or Equivalent _ Heaters Signs Ballasts No.of Devicesg or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications W No.of Devices or Ecir eat OTHER: Ira Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of 1 'cal Work: a (When required by municipal policy) Work to Start: ( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 BOND 0 OTHER 0 (Specify:) I certify,under the pains and penalties ofperjurz,that the Information on this application is true and complete. FIRM NAME: e* ir,cia, LIC.NO.: Licensee: ::\o has V40 Signature LIC.NO.: t 01, ,-I (If appl�icable.Anje�exem�t"In the license�} number line.) g Bus.TeL No.• d.'r_ , *Per M.G.L.c. l�7,s.57-6p seccuurity wo�uires fltPtt4r. cp eni of Public Safety" "License: TeL No.: S 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 amthe(check Owner/Agent Sione)❑owner ❑owner's agent. ure Telephone No. I PERMIT FEE:$ 50— I COJ