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Home My WebLink AboutBLDE-21-005135 Commonwealth of Official Use Only ifi ii Massachusetts'NI Permit No. BLDE-21-005135 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:3/11/2021 City or Town of: YARMOUTH To the Inspector of Wires: l By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 11 JONQUIL RD Owner or Tenant Elizabeth Hanson Telephone No. Owner's Address 11 JONQUIL RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check App t Bo )/ Purpose of Building Utility Authorization No. (( Existing Service Amps Volts Overhead 0 Undgrd 0 ; i f _ 4629 New Service Amps Volts Overhead 0 Undgrd 0 K/ e Lrn1, Number of Feeders and Ampacity O •Flip, Location and Nature of Proposed Electrical Work: Add additional receptacles in dining room, kitchen, &bathroo . f O Completion of the following table may be waived t - . , ! of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of `sue Transformers 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 5 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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 Kai' 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 ❑ (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: $75.00 a.:kGM 3(02-.11.-A g. Commonweal o/tt/aeeachusetie Official Use Only ' • it i c7� �7 Permit No. -Z\-51 35 2 rpartm.at a`Jipe-_cervices Occupancy and Fee Checked . 1.F . BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leave blink) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 tIAmp(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Ihtte: 3/10/11 City or Town of: M+-ttKauT►tP0 RT To the Inspector of Wires: By this application the undersignedgives notice of his or her intention to perform the electrical work described below. Location(Street&Number) i\ TaN pm L. R-a Owner or Tenant C L-t g A-$ETM HM/(� Telephone No. Sob yy��i f(a' Owner's Address r-' r +irl l [1 TN Ott-.. tt-D Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Banding Utility Authorization No. Existing Service s / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps Volts Overhead❑ Undgrd❑ No.of Meters -IA.,Number of Feeders and Ampacity Location and Nature of Propo Electirkal Work: r�_ - a s t l'r\k1 F—- Iv 5 ev V. Tilt . 6 t O V Tt- efrTtn_d'j v) 1-0 ALL- .1..) sTAvagiviohlpif ng� waived by the Inspector of Wires. lb No.of Recessed Luminaires No.of Ceil.-Sus .(Paddle)Fans NO "mil P Transformers KVA Z. KVA CI No.of Luminaire Outlets No.of Hot Tubs Generators Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grad. ❑ grnd. ❑ Battery Units J No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and Z. No.of Switches IIINo.of Gas Burners Initiating Devices III No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Rat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑Connection ❑Other No.of Dryers Heating Appliances KW No of Devices or Equivalent No.of WaterKVV No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNceor quiv Wiring: No.of Devices Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: j i 6b0 (When required by municipal policy.) Woric to Start 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 ❑ BOND 0 OTHER 0 (Specify:) I cerdh,under the pains and penalties of perjwy,that the information on this application is true and complete. FIRM NAME: Ei.tSAb€TH PrkArtJ LIC.NO.: expoker Licensee: Signature C 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 irLstpuice coverage normally required by law. By my si below,I hereby waive this requirement. I am the(check one)MITOwner 0 owner's Owner/Agent agent. Signature Telephone No. 64 Z1 s tiro y PERMIT FEE:S4 q 1 • c