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Home My WebLink AboutBLDE-23-003603 oR Commonwealth of Official Use Only Massachusetts Permit No. BLDE 23-003603 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:1/3/2023 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) 10 LOOKOUT RD Owner or Tenant JARVIS MICHAEL Telephone No. Owner's Address JARVIS LINDA, 110 CLUBHOUSE LN, NORTHBRIDGE, MA 01534 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: Wire master bathroom, and basement 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 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. Ton l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices Space/Area HeatingKW Local 0 Municipal 0 Other: No.of Dishwashers P Connection HeatingAppliances KW Security Systems:* No.of Dryers PP No.of Devices or Equivalent 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: Licensee: Joshua Jones Signature LIC.NO.: 23155 (I applicable,I a licable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 Pine Tree Circle,?Liefs Lane,Sandwich MA 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 ( e4 t/Z1( e . t..,ommonwealth 0/Mamadu ielLe Official Use Only / 2, i '_ i—'1, tt� Permit No. `/ -,23 l l�C� 2oparlmenl otq,e�ervece6 '1r.I ` / Occupancy and Fee Checked R E C ,,,,�,1F DBQARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) JAN k.t#,_'PL CATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 B •\._ i �i N"EASE FRIN71IININK OR TYPE INFO TION) Date: 1/3/ 2 3 BY. — y er- own of: 1 U,/�C 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) J 0 L- c k..r,-4,4- (dt Owner or Tenant 1-ell dal plc-✓vj5 / Telephone No. 5ci)-L?7- (c( Owner's Address I G i.-0•a 4- GG-4- ✓cam �0,+'v-z- ,. .r"4 Is this permit in conjunction with a building permit? Yes l!d' No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: kA/iy,� �,t 6,s.�..e,— 1„ .� ex,1 t�l tac..x.p � o) to Completion of the followinVable may be waived by the Inspector of Wires. otal No.of Recessed Luminaires No.of Ceil:Sus (Paddle)Fans No.roof TVA p• Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones ofand No.of Switches No.of Gas Burners No. InDete Initiatinngg on Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons...._..KW No.of Self-Contained p Totals: Detection/Alerting Devices Municp No.of Dishwashers Space/Area Heating KW Local❑ Municci tioal n 0 Other No.of Dryers Heating Appliances KW SreNo of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters I Signs Ballasts No.of Devices or Equivalent No.H dromass a Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or Equivalent � No.of Devices Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lec 'cal Work: I 0,CGG (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 E OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: oS L(n.vt �S G I %r LIC.NO.: _3 i 59,q Licensee: 1,5E r,,,q a.,,.e5 Signature .�. .�'E � LIC.NO.:_23/5'�=✓t (If applicable, enter " xempt"in the license number line.) Bus.Tel.No.: .S'''- 77- `1C/ Address: (�, 11ta9_ l tz G,.vt,C . -SC440 , itin( ,M4 02 5-63 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: 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 am the(check one)❑owner 0 owner's agent. Owner/Agent ( PERMIT FEE: $ Signature Telephone No.