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Home My WebLink AboutBLDE-21-007160 i a p i\` Commonwealth of Official Use Only E. or Permit No. BLDE-21-007160 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:6/9/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 15 HARBOUR HILL RUN Owner or Tenant PHILLIPO JOHN R III Telephone No. Owner's Address 662 CENTRAL TURNPIKE,SUTTON,MA 01590 Is this permit in conjunction with a building permit? Yes❑ No ❑ (Ghee gszj)// Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 ..5ta •New Service Amps Volts Overhead 0 Undgrd 0 ' ,f AD* Number of Feeders and Ampacity *NI Location Location and Nature of Proposed Electrical Work: Wiring for second floor addition&sub panel .V O) /VJ/aJ Completion of the following table may be waived b N •r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans 1 No.of ', Transformers •A 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 12 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 Data Wiring: Heaters Signs Ballasts 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 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 Ill 6CspC tS -Tthucyofitio 4 Pam) (12 -1, , 7/f319.4 k- l.ommo,uvaa&4 o f aadacLuaalfa Official Use Onl =" T cc�� nn Permit No. — 7fC-rO 2eparimant o/. irs Jarvics1 ;tt7 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (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 INFORM4TION) Date: J j jf..p 9, dt^,�j IRCity or Town of: '�44 f71 0(,(�f To the Inspector ofoWires: By this application the undersigned gives notice of his or her intention to perform the elecctrical work described below. Location(Street& Number) /,j /144{j G' (✓(n, j.�( (� 2,f.>CN Owner or Tenant �U�: ,t �1,�I L(� Pc: Telephone No. 5O8-704- -- Owner's Address j�S jyL/}4_�ci c[ti I4 i C.C- Au� v Is this permit in conjunction with a building permit? Yes Eg No ❑ (Check Appropriate Box) d; a .. Purpose of Building Res(7(7,t,-)/Kr Utility Authorization No. Existing Service c.2 D D Amps 2 2a hD Volts Overhead 17. Undgrd n No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters 0 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 2 ✓d E L c,c,i2._ , d cJ i / t c'„,,,,I .L, //+/l .., l l/Z2 Z 2c/i z 0✓ ya�,�� s�t 5 P4 sJEL /1 6,2 4Kic/f C,2C'J ITS 1 vlCompletion of the followingtable may be waived by the Inspector of Wires. No.of Total '4 No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA � No.of Luminaire Outlets No.of Hot Tubs U Generators KVA t No.of Luminaires ,3 Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting G rnd. grnd. Battery Units • No.of Receptacle Outlets /c No.of Oil Burners (3 FIRE ALARMS No.of Zones • No.of Switches 3 No.of Gas Burners V No.of Detection and Initiating Devices No.of Ranges D No.of AIr Cond. TotalTons No.of Alerting Devices No.of Waste Dis osers Heat Pump Number Tons K__W No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers 0 Space/Area Heating KW 0ILocal❑ Municipal Connection ❑ Other No.of Dryers 0 Heating Appliances KW Security Systems:* Q No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunicaions Wiring: �i No.of Devicets or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: SQQ ; t.,L (When required by municipal policy.) Work to Start: 61/c,1 al Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C 'ERA(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 ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (if applicable,enter "exempt'.in the license number line.) Bus.Tel.No.• Address: 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 ins n°ce coverage normally required by la y my signature below, I hereby waive this requirement. I am the(check one) owner ❑owner's agent. Owner/Agen 6 Q$•-712.5177S PERMIT FEE: $ Signature Telephone No.