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Home My WebLink AboutBLDE-19-000634 ' Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-000634 ftrti BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev.l/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date:7/31/2018 City or Town of: YARMOUTH To the Inspector of Wires; By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 108 WINDING BROOK RD Owner or Tenant ARCHIBALD MARY ANNE Telephone No. Owner's Address 108 WINDING BROOK ROAD,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Re-attach SEU cable&meter socket following re-siding. 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. grn . -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. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number ` Tons , KW No.of Self-Contained Totals: 1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 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: Charles K Swanson Licensee: Charles K Swanson Signature LIC.NO.: 12895 (/f applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:718 CEDAR ST,W BARNSTABLE MA 026681300 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 ejZ ^ /'/t6J it l.ommana ra[fh o�I r/attaclwhtts Off se pal Z,1 `e�; 1JaPartment f,.Yin J' Permit No. �C.J c/ a e vfui 1'�`£ Occupancy and Fee Checked �Q�/ mss` BOARD OF FIRE PREVENTION REGULATIONS r�(� ev. 1/07J (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 pa 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORM/1770119 Date: 7 - 3 I City or Town of: YARMOUTH To the Inspector of Wires: • 0 r- _ Z y this application the undersigned nes n/oti`c�e of h' or her i tion t perfomAe electrical work described below. ij„-,__ . !s cation(Street&Number) �d �i i+)C� ra N IQ I wrierorTenant C(�y(ZC� �ec.c Or ( Telephone Na. �nT4 wner's Address f J s this permit in conjunction with a building permit? Yes No 0 (Check (,} z . ee � Appropriate Box) U _-, ° urposeofBuilding 5ttJtt q t l Utility AuthorEzstion No. 5 zisting Service Amps / Volts Overhead 0 CC: m Undgrd 0 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: it 4 +C(A 6t.ro?ct. Cct�lC G !l tri r SceLTi ar V tc4s Sid?"-c? uK Completion of the following.table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil Snsp.(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.al...Emergency Lighting grnd. grvd. 0 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 No.of Ranges No.of Mr Cond. Total No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number Tons I KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - No.of Devices or Equivalent OTHER: - • Csa Attach additional detail(desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (00 • (When required by municipal policy.) Work to Start: 7- 31' (g 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 certify,under the ins and pen s ofperjury,that the information on this application is true and com feta�/n) FIRM NAME: d.[ h56111 LIC.NO.:Ti 1 A Licensee: Signature/1 LIC.NO.:tr i'(OLrt Address: thelicenzrmmbe7frrc.) 5` '( ��1�r Bus.Tel.No.: �2 b(G ( Address. /t 2$ (7o/ t C.� Steil li• c41 Alt.Tel.No.: j *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 insurance coverage normally 1. required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/Agent j Signature Telephone No. .•.• ( PERMIT FEE: $