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Home My WebLink AboutBLDE-22-007399 Commonwealth of Official Use Only i Massachusetts Permit No. BLDE-22-007399 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:6/24/2022 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) 99 CENTER ST Owner or Tenant JALICKI CONSTANCE Telephone No. Owner's Address 99 CENTER ST,YARMOUTH PORT, MA 02675-1311 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 0 , Existing Service Amps Volts Overhead 0 Undgrd ❑'. o.of Meters New Service Amps Volts Overhead 0 Undgrd E2�t') 9. f Jeetere) Number of Feeders and Ampacity .. J' j V 447Y81 Location and Nature of Proposed Electrical Work: Split A/C. </� Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- ❑ No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Air Cond. 1 Total No.of Alerting Devices No.of Ranges Tons No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices 0 Municipal No.of Dishwashers Space/Area Heating KW LocalConnection ❑ Other: Security Systems:* No.of Dryers Heating Appliances KW No.of Devices or No. No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Signs No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 LIC.NO.: 11925 Licensee: Jonathan R Hall Signature Bus.Tel.No.: (If applicable,enter"exempt"in the license number line.) Alt.Tel.No.: Address:263 CAMMETT RD, MARSTONS MILLS MA 02648 *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 0 owner ❑ owner's agent. signature below,I hereby waive this requirement.I am the(check one) I Owner/Agent I PERMIT FEE: $50.00 Signature Telephone No. RECEIVED E JUN 2 31 22 a! CommontosaGth o/Kidac Cudsrid Official Use Only BUILDING L , *� cc� c��/ Permit No. ZZ'� �'� ■ 2epartmsni of irr ervicse ' BY Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK L All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 CMIt 12.00 .. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �a 3 f 3 2 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. 'T Location(Street&Number) q CI c .- /)`T r,c Y'ict-iii PC)r ,2 Owner or Tenant C 1 j _e_t ' j I!c is Telephone No. eJ Owner's Address Is this permit in conjunc on with a building permit? Yes ❑ Noe (Check Appropriate Box) Purpose of Building s Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd El No.of Meters Number of Feeders and Ampacity 053 Location and Nature of Proposed Electrical Work: 6 G I ' Completion of the followingtable may be waived by the Inspector of Wires. uss t,L No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA '1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA 1 Swimmingpool Above In- No.of Emergency Lighting 't No.of Luminaires grind. 0 grnd. ❑ Battery Units _ `r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and s Initiating Devices 111 No.of Ranges No.of Air Cond. Total No.of AlertingDevices Tons 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 ❑ Oth ConnectionOther No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.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 Wirin No.of Devices or Equivalent : OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: od _ (When required by municipal policy.) I Work to Start: (012 3ta 2 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 eov ge 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 of perjury,that the information on this application is true and complete. FIRM NAME: To ,A W At(1 (7 Licensee: `J0,,ry,,.)tl,r,, o(,1 Signature " LIC.NO.: (f c( )'(3 (If applicable,enter"exempt"in t e licensetv'number line Bus.Tel.No.• 32P r!. .u/L? Address: a(,,,,a(,,,, C ctitv , S t,M',)) .A )4c.s r' ,(( Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires I)cpartment of Public Safety"S"License: Lie.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: $ J U G<<+f