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Home My WebLink AboutBLDE-23-002789 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002789 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:11/18/2022 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) 9 ESSEX WAY Owner or Tenant Ann Lang Telephone No. Owner's Address 9 ESSEX WAY,YARMOUTH PORT, MA 02675 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 basement, bedroom, bath and bonus room . Install smoke detectors 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- ❑ 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. 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW ▪Security Systems:* N▪ o.of Devices or Eauivalent 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 Eauivalent 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 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:6 Pine Tree Circle,7 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 11-7_74-72 (S\J A c/27(Z3 k � f -/iq , - C y R E ___-._..�._�� Mad:Sac/m.19thOfficial use Only nwaa o l '-------74;7-,f' Permit No. �'�`NOV 18 2022'' �s artrnQnt �inQ Serviced =re- � P 14 =� = l Occupancy and Fee Checked y, -rail' -, _4?Uli le f � i REVENTION REGULATIONS [Rev. 1/07] (leave blank) — By: _�--- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC) 527 C 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I 1 i L 7 2..2— City or Town of: i(a.frergitlk 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) Cl 5 x (A.A Owner or Tenant Jcvt h Telephone No. , -).:77.- C tic( Owner's Address CIE f_vrt9-,Li.„‘•-ki Is this J permit in conjunction with a building permit. YesLkNo (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service (CP" Amps / Volts Overhead 111 Undgrd 11 No. of Meters New Service Amps / Volts Overhead Ill Undgrd III No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: �.y , J �t / A 4- 1( Jcit �� licc-�- S 4,�ecl -o1 Levy-atr 4Prf_a �tS/ ` c Compltatan of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. Tr KVA Transformers KVA(Paddle) Fans of No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires SwimmingPool Above r—i In- ❑ No. of Emergency Lighting grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones ofSwitches No. of Gas Burners � No. of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total g Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number_Tons KW ... No. of Self-Contained p Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local El MElOther,pConnection Heating Appliances KW Security Systems:* No. of Dryers No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. H y No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electri Work: T7CCC (When required by municipal policy.) Work to Start: ( I /i 7/)4.. 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE El 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: i L c ) LIC. NO.: 13 /'5 5-4 Licensee: je. c Signature �i LIC. NO.: 25 / 5�6 -4 (If applicable, enter exe pt in the license n ber line.) Bus. Tel. No.: 5C 71-ctt ci Address: 6 i, .4-e- i Scit-tol c GL A A 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) El owner 0 owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No.