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Home My WebLink AboutE-17-5439Commonwealth of Official Use Only K a! Massachusetts Permit No. BLDE-17-005439 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 (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORAfATION) Date: 4/2412017 City or Town of. YARMOUTH To the Inspector of ;Vires: By this application the undersigned gives notice of his or her men on to per orm the e ec sa work described below. Location (Street & Number) 51 WINTER ST Owner or Tenant SWANSON DAVID B Telephone No. Owner's Address SWANSON SHEREE L, 51 WINTER ST, YARMOUTH PORT, MA 02675 Is this permit In conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Bos) 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: Repair code violations and add smoke detectors Comoletlon of the followine table may be waived by the Insnertnr of IVirom No. of Recessed Luminaires No. of Cell: Susp.(Paddle) Fans No. of Transformers Total KV No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ read. In- [3No. rnd. of Emergency Lighting Ba tery Unit 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. .TTotal No. of Alerting Devices No. of Waste Disposers Heat Pump TotsH: umber 7bm KW No. of Self -Contained Detection/Alerting Devices I I No. of Dishwashers Space/Area Heating KW Local ❑ MunlclPsl E3Other: Conn ection No. of Dryers Heating Appliances KW Security Systems:* N of vi or nuivalent No. of Water KW Heaters No. of No. of siffni Ballasts Data Wiring: No. of D vices or E uival n No. Ilydromassnge Bathtubs No. of Motors Total IIP Telecommunications Wiring: No.n nevi n ul glen OTHER: Attach additional detail Il desired, or as required by the Inspector of iVires. 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 certify, under the pains and penalties of perjury, that the Information on this application Is true and complete FIRM NAME: William C Fligg Licensee: Wiliam enter LIC. NO.: 12584 Bus. Tel. No.: Address: 55 FREEMAN RD, YARMOUTH PORT MA 026752304 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) Cl owner Cl owner's agent. Owner/Agent Signature Telephone No. / PERMIT FEE. 5250.00 CZAC— 2 CIW9G I?CX � �P . • �/ss Lt,,_!y� rcial Use lin • � („on,rnow+uaalth I r//aetac c�- a�� c� �irvicaa Permit No. BOARD OF FIRE PREVENTION REGULATIONS Otroancy and Fee Checked 71 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Eleet HeAl Code (MEC). 327 CMR 12.00 (PLEASE PRINT IN INK OR PTIE ALL IhT'O M4770N9 Date: I City or Town of. , • i To the Inspector of Vires: By this application the undersigned gives n h'ltion t orm the el etrieal work bed below. Location (Street & mber) Owner or Tenant v d vk T lephone No. Owner's Address Is this permit 1n conjunction with a building permlC: Yes ❑ No D (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service - Amps!) / (� Volb Overhead E]'O� Undgrd ❑ No. of Meters New Service Amps / Volta Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity Lo sthku and Nature of Proposed Elec&IW Work: n/1,...r n . 1. lir , , L.L.. .1.L_ B.L.. 11 .-Lt- _- t_ _ ._.__�.__ d . . No. of Recessed Luminaires No. of CeB�Susp. (Paddle) Fans v'.nC IrtJ illlV "I/ . °' of °m TransformersKVA No. of Laminalre outlets No, of Hot Tubs Generators KVA No. of Laminalres Swimming PoolAbo ve ❑ o- Md ❑ o. o mergency Lighung Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Barnes No. of Detection and Initlaflng Devices No, of Ranges No. of Air Cozad. Tons No, of Alerting Devices No. of Waste Disposer HestPumplNumr TotsN. o. o ontare Deteetion/Alerttn Devices ' _ons _` '— No. of Dishwashers Space/Ares Heating KW Local ❑ Muniu ❑Other Coottnneetlon No. of Dryers Heating Appliances KWSecurity uri of Oculus or Equivalent No. o eater KW Heater o. o a. o g s Ballash Data Wiring No of Devttxs or ret No. Hydromassage Bathtubs No. of Motor Total HP a eeommn onsgg:: No. of Devices or ukalent OTHER nrw m mammw acwrr y aestrea or as required trp rete Impector of Whys. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: \ —12 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 covegge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Er BOND ❑ OTHER ❑ (Specify:) I cerlfy, ander the pains andpenaldes fperjxry {/tat flee hrjonnadon on this xpplieadon is trxe and complere. 7 NAME: )\ �c C LIC. NO.:� �3 Lieensee. t Signature LIC. NO.: (if appAddr/ieabte, er "ernwpr- hr the liceme tire./ Bus• Tel. No • l CI Address: Alt. Tel. No.: •Per M.G.L. c. 147, s. 57-61, securitywork requires Department of Public Safety "S" License: Lie. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee doerTrot have the liability insurance coverage normally required by law. By my Signature below, i hereby waive this requirement. I am the (chec[%NRMM1TFEE. owner owner's RML Owner/Agent Signature Telephone No. 5