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HomeMy WebLinkAboutE-18-1766 �(jln Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-001766 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked FRev.1/07i 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:9/26/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorin the electrical work described below. Location(Street&Number) 25 TROWBRIDGE PATH Owner or Tenant THAYER GERALD F Telephone No. Owner's Address THAYER LAURIE M, 149 BENT ST, FRANKLIN, MA 02038 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 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: Replacement furnace 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 0 In- ❑ No.of Emergency Lighting grnd. grnd. Batten,Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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.ofJ)evices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail rfdesired,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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (Lfapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 (C4, ‘ efri/ y Canwwnw�of///a65ac • - be ••ly fn -- A I! le rs•r� c7 ��ii Permit No. /(I =T apartmcni a{.Jiro&mime Jr � \ • --- _� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS et 1/07] ' peeve blank) C� APPLICATION FOR•PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 (PLEASE PRINT IN INK OR TYPE ALLINFOR&L4TION) Date: 7/a /7 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) a r—tit evaj A I\ j,, .41-144 Owner orTenant ..4.......4.....A A (,4 -1-14...91.e4 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes E No ❑ (Check Appropriate Boz) • Purpose of Building Utility Authorization No. zistiag Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters �� . ew Service W t� • RFs / Volts Overhead 0 Undgrd 0 No.of Meters a N \ umber of Feeders and Ampacity co a .cation and Nature of Proposed Electrical Work: �� � v( n/ /.. 11.1 � -� 1`_�`�-��� W _ Completion o/thefo/lorometable may be waived by the Inspector of Wires. 11i N 1 No.of Recessed Luminaires No.of Ceti�trsp.(Paddle)Fans No,of Total I Transformers KVA 1 1 m a O. of Luminaire Outlets INo.of Hot Tubs (Generators • KVA ' • No.of Luminaires ISw•• mina pool Above In- No.or Emergency Lighting - crud. urn& 'No. Units No.of Receptacle Outlets . No.of Oil Burners IFTRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and — Initiating Devices • No.of Ranges INo.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers (Heat Pnmp I Number I Tons I KW No,oiSgrf-Contained Totals: De.Di'Son/Alertino Devices No.of Dishwashers ISpace/Area Heating KW' Load Municipal ❑Connecti°n 0 Gther No.of Dryers (Heating Appliances KW Security Syyssterns:• No.of Water Heaters KW No. of No.of Data No. nces or Equ •ivalent 1 Signs Ballast No.of Devices or Equivalent No.Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: - No.of Devices or Equivalent (e 01HER: — 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 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. 0 CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify.) Tal I certify, under the pains and penotnSc ofperjury,that the information on this application is true and complete FIRM NAME: LIC.NO.: Licensee:c� s,/ �" 61-7,.."...10 /) �� 7���c..-• Signature I! LIC.NO.: j© A (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.• _ . Address:1//t. @l&.c) S L,,. riga Tnals Ms.L4" o.Qd 4°2-1. f Alt Tel.No.:caZ2 - J `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. �xOWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally S requiredAent bgy law. By my signature below,I hereby waive this requirement T am the(check one)0 owner 0 owner's agent 1 Signature Telephone No. l PERMIT FEE: S