The URL can be used to link to this page

Home My WebLink AboutE-03-647APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 OF yq (OFFICE USE ONLY) RE g -- -- = T I _ A UTH By_� MATTACHEESE � A>�0 ,� � ;� � /vC,7 � Fee: $ �rx I' I 3 PERMIT NO. �G3 Y (PLEASE PRINT IN INK TYPF�F�R 1 ION) Date: 2 3 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) " / 0Of r k?eS 44"e 46 YQ/''A-1-1 0V 1'W-1 Owner or Tenant kIC .S 42 C t7 P- (--o L7_I- 14r, Telephone 0 Owner's Addres Is this permit in conjunction with a building permit? 0 Yes 0 No (Check Appropriate Box) Purpose of Building /- 0 tyl e�— Utility Authorization No. Existing Service Amps / Volts Overhead Undgrd C1 No. of Meters New Service 50 Amps 12_-C` /2 Volts Overhead Number of Feeders and Ampacity Location and Nature of Proposed electrical Work: Undgrd q No. of Meters C tlE' Completion of the following table may be waived by the Inspector of Wires No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool grnd. gmd. No. of Emergency Lighting 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 Total No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Totals: Number — — — Tons — — KW — — No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local Connection Other No. of Dryers Heating Appliances KW Secutity Systems: No. of Devices or Equi valent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. H dromassa a Bathtubs y g No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued 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 M BOND C1 OTHERC] (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start:,3 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: G LS LIC. NO. % �� • 3 / Licensee: Signature," a14V--- LIC. NO. (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: Address; Alt. Tel. 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 Cl owner's agent. Owner/Agent Signature Telephone No [Rev. 04/00] APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .� All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 ? OF 4q� (OFFICE USE ONLY) ~3 TOW NrOF ARMOUTH By WT, ..ESE Fee:$ / , L ��_'OU_ I I Mr,,R 1 $ 3 L PERMIT NO. t_-03-- ' (PLEASE PRINT IN INK TYP / / TNFn&M ION) Date: 3 3 To the Inspector of Wires: y t is application the undersigned gives notice of his or her intention to perform the electrical work described below. � // Location (Street & Number) cam.. 1 t/I<'r V7(' S �Ci 1 C' �Y �g/ N D(Jt�1 Owner or Tenant "C ------Telephone No 6OR`'F-Q'_�Sd 0 Owner's Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building I'T 0 tlI toUtility Authorization No. Existing Service Amps / Volts Overhead❑ New Service d Amps /2.0 / 2`f(iVolts OverheadQ Number of Feeders and Location and Nature of Proposed electrical Undgrd Q No. of Meters Undgrd No. of Meters 01-bf tnsuectorofWires No. of Total No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans Transformers KVA No. of Li htin, Outlets No. of Hot Tubs A n- Generators KVA No. of Emergency Lighting No. of Lighting Fixtures ove SwimmingPool md. gmd. ❑ Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones o. o erection an No. of Switches No. of Gas Burners Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices g Heat Pump um er ons KW — — No. of Self -Contained No. of Waste Disposers Totals: Detection/Alerting Devices Municipal Local ❑ Other No. of Dishwashers Space/Area Heating KW Connection Security Systems: No. of Dryers Heating Appliances KW No. of Devices or Equilivalent No. of Water No. of No. of Data Wirin No. of Devices or Equivalent Heaters KW Signs Ballasts Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or uivalent l d 'L ' d ire-4 or as required by the Inspector of Wires. Attach addttrona etas rf esr q INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued 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 ;7 BOND❑ OTHER (Specify) r J (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Starter 1 — d. v Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penal[ieg of perjury, that the information on this application is true and complete. '/- Z FIRM NAME 6k7 J>r ti imW �c LIC. NO. � Licensee: Signature " r r LIC. NO. (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.. 'P�ez Sf- Address• Alt. Tel. No.. OWNER'S INSURANCE WAIVER: 1 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 ❑ owner's agent. Owner/Agent Signature Telephone tRev. 041001 '- OV p, TOWN OF YARMOUTH ?g Building Department i Town Hall Yarmouth, MA 02664 (508) 398-2231 ext.261 Ev Building Location: 00021 BARNES LN Owner's Name: McShane Construction Owner's Address: 00021 BARNES LN PERMIT TO PERFORM ELECTRICAL WORK (OFFICE USE ONLY Recorded By: Ic PERMIT NO. Permit Fee: $125.00 Payment Type: Check Check Number 3021 Issue Date: 3/18/03 Type of Work: New West Yarmouth MA 02673 Owner's Telephone: (508) 428-8500 Electrician Name: Szimmetat, Hans License Number: 21391 Company Name: Company Phone: (508) 280-8945 Comments: new construction INSPECTION RECORD Date Printed: 3/20/03