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Home My WebLink AboutBLDE-23-001584 Commonwealth of Official Use Only -1 , Massachusetts Permit No. BLDE-23-001584 sirc ,% 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:9/26/2022 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) 26 FESSENDEN ST Owner or Tenant LANTZ DIANA A Telephone No. Owner's Address 8268 CAPTAINS WAY, NORFOLK,VA 23518 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: Install generator 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 1 KVA 14 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 Initiating 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 Signs 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 of perjury,that the information on this application is true and complete. FIRM NAME: FRANCIS D JONES Licensee: Francis D Jones Signature LIC.NO.: 13534 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:309 Neck Rd, Rochester MA 027701700 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: $80.00 O fleia CornmonWev el aoaachueetle 23'(S I >__**7-,m-o'_. ParnifNo,• L efar nsnt o ire Serviced BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev, I/07J (leave blank) APPLICATION FOR PERMIT TO PERFORM ELEC CAL All work to be performed in accordance with the Massachusetts Electrical Code(MEC),$2�C R 12, WORK (PLEASE PRINT IN INK OR TYPE AL INFOkWiTION City or Town of, Date: By this application the undersigned gives: ti I To the inspector of Wires; f his qi her intend n to perform electrical work described below, Location(Street 8i Number)y� 67iJ'1 Owner.or Tenan `t • � h L j Owner's Address _„�Tslephone No, Is this permit in conjunction with a building --^! 3 3 , Purpose Building permit? Yes No (Check Appropriate Box) • Existing Service Amps Utility Authorization No, p / Volts Overhead E Undgrd NewNeweryioe Amps / g No,of Meters Yolts Overhead Undgrd E. No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed EIecfricai Work: o i Corer Idle) o•the folloivin table nr be tyalved b the Ins ec[or o Yl�tres, NO.of Recessed Luminaires No.of Ceil,•Susp,(Paddle)Fans \� o,o No,of Luminaire Outlets Transformers Z{dip, No•of Hot Tubs Generators W£VA .No.of Luminaires Swimming Pool ove ❑ n- iTlo.o mel'gelicy rg i ng No,of Receptacle Outlets rnd, rnd' ❑ Batter Units No,of Oil I3iu•uei•s . --- ---__._. No,of Switches FIRE ALARMS No,of Zones No,of Gas Burners o,o election vic No,of Ranges 4 o a _,e„ InftiAtin Deyieas No,of Air Cond.No,of Waste-------Disposers Tons No,of Alerting Devices posers eat ump um er ons Totals; � • ....,.•,,,,,,,,,,,,,,,, o>o e e ,orita net' • No, of Dishwashers Detection/.4Iertin_Devices Space/Area Heating KW Tunic No,of Dryers A lfanees Local C Heatinonne lion ❑ Other g pp TCWcu i ity stems,TM o,.o ater No,of suites or uivatenE____TM Heaters KW o,o Si ns Ballasts • Data Wiring: • No,Iydromassage Bathtubs No,of Devices or E uivalent• No, of Motors Total HP Telecommun cations. n•ng, OTHER; No,of Devices or E uivalent Estimated Value of Electrical it al Work; attach additional detail(cipalerl or as regarG•ed by the Inspector of YYtres.Work to Start: (When required by municipal policy,) W ork.tANCD Inspections to be requested in accordance with MEC Rule 10,and upon completion, 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: INSURANCEq t, I eert‘}y,under t/re pains,and penalties 0 OTHER ❑ (Specify:) r cert ,undo NAME: a f er;Ittry,that the information on this application true and complete, Oi ' 1l � / Licensee: a `� afapplicab'le,enter " • ill'?"to the license rnrur er lin Signature Address: �¢.LIC,NO,: "Per M.G,L,c, I47,s,57-61,security work requires b P Bus,Tel,No,: • OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance ance cover""`" partment o Public Safety"S"License: Lic,No, rewner/'by law, By my signature below,I hereby waive this requirement, I am the(check one)0owner Owner/Agent age normally Signature _____,y0 owner's a ens, Telephone No, P RM1T L r