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Home My WebLink AboutElectrical Permit (� � Commonwealth of Official Use Only � � Massachusetts PermitNo. BLDE-16-006235 ''"'�' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.l/07 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NfEC),527 CMR 12.00 (PLEASE PRINT IN IA�K OR TYPE ALL INFORMATION) Date:5/16/2016 Clty OC TOWII Of: YARMOUTH To the InspectorofWires: O By this application the undersigned gives not�ce o is or er mtent�on to pe orm t e e ectnca work described below. O Location(Street&Number) 74 PINE GROVE RD Owner or Tenant BOWIE ROBERT B Telephone No. Owner's Address 903 FRONT ST,WEYMOUTH, MA 02190 Is 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 ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work „'.� . �� 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 rnd. rnd. Batter 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 Initiatin Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Dispos Heat Pump Number Tons KW No.of Self-Contained � Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal p Other: Connection No.of Dryers a ' Appliances KW Security Systems:* No.of Devices or E uivalent No.of Water K`,�, .of No.of Data Wiring: Heaters i ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors 1 Total AP Telecommunications Wiring: No.of Devices or E uivalent OTAER: Attach additional detail if desired,or as required by the I�sspector 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certifj�,under the pains and penaLties of perjury,that the information on this application is true and complete. FIRM NAME: STEVEN J PAINE Licensee: STEVEN J PAINE Signature LIC.NO.: 12743 (Ifapplicable,enter•"exempt"in the license number line.) Bus.Tel.No.: Address: 108 CONSTANCE AVE,W YARMOUTH MA 02673 Alt.TeL No.: *Per M.G.L.a 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 t ��.. C�� "� �� 5 { �� .�� , ��: � ,��o �'��, .... �� ... , ��,�� Ih1�' -�,:� 2016 ____--___ t��ALTH DEPT.