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Home My WebLink AboutBLDE-19-000912 • Commonwealth of Official Use Only aE_ Massachusetts Permit No. BLDE-19-000912 kraBOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.i/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 INFORMATION) Date:8/15/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to pertorm the electrical work described below. Location(Street&Number) 30 PHEASANT COVE CIR Owner or Tenant MIKLAVIC MARK F Telephone No. Owner's Address 30 PHEASANT COVE CIR,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repairs to post light. 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- 1:1No.of Emergency Lighting grnd. grnd. 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: 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 , No.of No.of Data Wiring: Heaters Siens 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: WALTER W KELLY Licensee: Wafter W Kelly Signature LIC.NO.: 51391 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:7 MONROE LN,WEST YARMOUTH MA 026732731 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,secunty 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 0 owner's agent. Owner/Agent Signature Q Telephone No. PERMIT FEE:$50.00 9€ J ( ' e/w2ett- jiJir � . P1 cN- /4/17/. 4 arum-irwcJ5 oil Mt-i uci I....f'! C icinleOnitl .LcparFvr1cnE eF J�v..�'ertr�y r.Petsit No. BOARD OF FIRE PREVENTION REGULATIONS rev. Occupancy andFeeChecked -------' CS Pie blank) \ , APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK • .All wort to bep_i tmin accordance with the Massachusetts Electra!Code(MEC),527 Civ,R 12DD (PLEASE PIOTEJDEORTYPE ALL DVFORWIT10A9 Date: o r- City or Town of: YARMOUTH I: I To the Inspector of k dens_ mai wBy application on tSeµfides wedvrs no: a of his or her intention to perform de electrical work desrnbed below. m ` Location (Street&Number) 0 ( '1....%- COTe N • to • t� Owner or Tenant Lee '�ce S II�t4N (dA .,-, Telephone ? 0+� Owner's Address S 1c414..--t W I ¢ at 1 Is this permit in conjmaction with a bmlding permit? Yes ❑ No .a (Check 4 ro Purpose of Building ppPn to Boi) - rimg , Utility Anthorttation No. 1 Fasting Service_ Amps / Volt Overhead L1 Uad.rd❑ No,of Meters __.- New Serviee Amps / Volts Overhad❑ Und 0 NO.of Meters Nab of Fe. era and"ntpadty Location and Natter_of Proposed Mect inl Work: Act 14/� v L47$ Door- foS! �/ 1•f-T '�y�, �� e Q " - •-- - - Completion of the[oIIawat t e may be cathed by the lreveaor of Fires. J No.of Recessed Lan:.,.: INa of Ca_Sasp,(Paddle)Fans ' INo•ofasformers Total TtzICVA No. of Luminaire Outlet INo.of Hot Tubs Generators • 1CVA ' • 3 No. of Lataiaair-s ISwir.+�.,:ngPoo! '�OVe is-. rro.ox r,me,scy Laagnanv - /', orad. crud. TBEttsrr IIafa No. of Receptacle.Otr,L-t INo, of Ott Ewers — I ALARMS JNo. of Zones (_ No, of Switches I_Ne,of Gzs Braa:rs I-R'd of D-_tr_non mad No, of nes I Iartiatmo Devices Ra4a Ha of Air Cond. Total No,of Alerting Tons Devices No.of Waste Disposes, I BeatPomp I Number Tons 1 KW 4No.of Setf-Gontaia Totals: I Derartiott/.4lertiao Devics �� No. of Dishwashers ISpace/Area Heating TCW' ILoizi 0 Maaidpal No. of Dryers F- Co ecnon0 ? �p Heating Appliances KW Secartty Systems:• No. of Water I No.of Devic es or Equivalent Heaters TCW No. of No. of ID Wirmg Sins Ballast I Na of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total AP ITelecotnmamtaaons Wring 2 OTHER No.of Devices or Equivalent • • Attach additional detail tfdSree or m required by the Inspector of Wirer, �/ Estimated Value of Electric-al Wary` Work to Star4 (When required by mimicipal polity.) ...� Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,to permit for the performance of electrical work may issue unless • the licensee provides proof of liability insurance including"completed operation"coverage or it substantial equivalent The undersigned certifies that such coverage is in force,and has uhubitcd proof of same to the permit issuing ou'Sce. grni CHECK ONE: WSURANCE,� BOND 0 OTHER 0 (Specify.) r cerSfy, ruder the •tarts and .=aid=o FIRM NAME: -- • fp' ' ', athe informrffior:on this application is true and corrzpide, a► C L C L ."./C.-_ ."./C.- LIC NO:a Licensee I I S" ,atur�/Wald Lie.NO.: afapp b .ante many!"in the mtmber line) Address: Ens.TeL No. p ,,,1 `Per M.G.L. c. 147,s_57-61,securityAlt.Tel.No OWNER'S INSURANCE WAIVER:work my that th Lice of Public nor Safety have the License: Lin,e c Q I am aware chef the Licenses does nor liability insurance eovesage n t regtated by law. By my si enatore below,I hereby wive this requirement I am the(check one 0 owner 0 owner's agent Owner/ eat Signatre Telephone No, PERMIT FEE: S coO