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Home My WebLink AboutBLDE-23-000518 Commonwealth of Official Use Only fi_ 1 Massachusetts Permit No. BLDE-23-000518 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:8/2/2022 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) 81 BLUE ROCK RD Owner or Tenant Ben Seymore Telephone No. Owner's Address 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 ❑ 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&dining 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. Tot l 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 ❑ Municipal ❑ 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 ❑ (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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 QL)(0446 (3/2,9, 1 'L w. , . � l ' �' RECEIVED ^(\�] o-_2022 y� will ee`� • �, AUG tr/aeaac�irWatfa Official Use Onix •�;e._ , I BU ILDINGDEP�H Jim Jaruicas Pcrmi[No. II BY ARD OF FIRE PREVENTION REGULATIONS Revc pancy and Fee Checked (leave blank) j APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed hi accordance with the Massachusetts Electrical Code( 527 CMR 12.00 V C (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (� 1 ..zZ City or Town of: YARMOUTH To the Inspector of Wires: . - By this application the undersigned gives fhis or/h-e�r Wald"m perform the electrical work described below. Location(Street& mber) U r2.0 C_i �' Owner or Tenant PjV CAos yq ey t`Id t ii me mg- Telephone No. Owner's Address Sl4n^-4... (r`'``•tL-(- Is this permit in conjunction with a building permit? Yes Q No r. ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. ( � Existing Service Amps /20/ay i5 Volts Overhead El Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters f Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: A--1 -/, pys...) NNt ,` /e Yi.,7� ss J 711 ' Completion of the following table may be waived by the inspector of Wires. tli No.of Recessed Luminaires No.of Ceil.-Snap.(Paddle)Fans Tr.of 7 oral t� Transformers KVA <1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA k No.of Luminaires • Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units • . No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and < Initiating Devices III No.of Ranges No.re Air Cond. Total No.of AlertingDevices Tons No.of Waste Disposers Totals: Pump Number Tons KW 'No.of Self-Contained - Detection/Alertln Devlcee No.of Dishwashers Space/Area Heating KW Local 0 Munionnectiocipal n 0 Other C No.of Dryers Heating Appliances KW SecNa o Systems:* Devices or Equivalent No.of Water ICµ, No.of No.of Data Wiring: Heaters Ballasts Signs No.of Devices or Equivalent No.Hydromsauge 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 Val o Electrical Work: (When required by municipal policy.) Work to Start i t"c.)-;;;'- Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE 0 RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability'nsurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) 11 1 certify,under the ins and penalties of, rjury,that the information on this application is true and complete. �) /m^JJ LIC.NO.: it4 yid FIRM ryp�{�''� Licensee<,i: . rr 4 ti Signature WC.NO.: <f4� (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 997 1"9 ck./ Address: Alt.TeL No.: °Per M.G.L.c.147,s.57-61,security work requires Department o ublic fety"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)❑owner 0 owner's agent. Owner/Agent Signature Telephone No, (PERMIT FEE:$ 7s—