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Home My WebLink AboutBLDE-23-002509 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-23-002509 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:11/7/2022 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) 3211 HEATHERWOOD Owner or Tenant JULIE NOLAN Telephone No. Owner's Address 3211 HEATHERWOOD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Remodel kitchen &bath room. 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 Initiating Devices No.of Ranges No.of Air Cond. ,Total No.of Alerting Devices 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 0 Municipal Connection 0 Other: 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR, S YARMOUTH MA 026641339 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 -gekret-I h1-77 44 3 g•••• .14. I 1` RECEIVED lc ;� NOV 07 20 _ // .... �, � o� aaeachueste Official Use Only iY - ',.B-: •y ILDING DEPARTNFNT aIL� - a (`�^ -- . : .(� Permit No. Oz:} •-.. s nE oil giro -gamiest' 1; ~' i Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07� (leave blank) 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: /P/ -2 /0). i• City or Town of: YA R M O U TH To the Inspector of Wires: By this application the undersigned gives notice of is or h ' tention to perfop9 the electrical work described below. Location (Street& Number) , 3 ,21 f -- (17 1,06.0 _- Owner or Tenant i U// e /�0/r}f� S',. Telephone No. f Owner's Address Cx11 ,� Ia this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd it ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd g ❑ No. of Meters f-,...____ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: J - c v Lb v� Completion of the followin&table may be waived by the Inspector of Wires. No. of Recessed Luminaires No.of Cell.-Soap. (Paddle) Fans No. of Total Transformers KVA C.t No. of Luminalre Outlets No.of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- No. of Emergency Lighting � _grad. grnd. � Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No. of Switches c. No.of Gas Burnerso. of Detection and t No. of Ranges Total Initiating Devices 11: No.of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers -feat Pump Number Tons KW No. of Se - onta ne Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal No. of Dryers Heating Appliances KWSecurity Systems,:*tion a �� No. of Devices or No. of Water No. of No.of Equivalent Heaters KWSigns Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires, Estimated Value o Electrical Work: Work to Start:/0 � o�02 Inspections (When required by municipal policy.) to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C RAGE: 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 issuin office. CHECK ONE: INSURANCE 1..6°, BOND ❑ OTHER g I certify, under the pains and penalties rjury, that the information on this a lira ' FIRM NAME. 7 PP ton is true and complete/ ja Licensee: a G LIC. NO.' \ r/ (If applicable, enter "exem� .in he license mber live.) Signature LIC. NO.: f Address: c_,/ t, `,6 A.,1 u V� l( 0 V �4 Bus. Tel. No.. f *Per M.G.L. c. 147, s. 57-61, security work require� Department of tic fe "S" License: Alt. Tel. No.: Lic. No.OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage required by law. By my signature below, 1 hereby waive this requirement. i am the (check one 8 normally Owner/Agent owner • owner's a:ent. Signature Telephone No. PERMIT FEE: _ , 1 • : • . , . . • , •