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Home My WebLink AboutBLDE-19-000924 —e. Commonwealth of Official Use Only Itti ��= Massachusetts Permit No. BLDE-19-000924 �7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/07) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Al 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:8/16/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his of her intention to pertorm the electrical work described below. Location(Street&Number) 51 CIRCUIT RD NORTH Owner or Tenant FITZGIBBONS JAMES J Telephone No. Owner's Address FITZGIBBONS SHARON L, 11 MANOR RD,AUBURN, MA 01501-3138 Is this permit in conjunction with a building permit? Yes ❑ 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Septic pump&alarm. 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. 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 1 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.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 ❑ BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Timothy A Willman Licensee: Timothy A Willman Signature LIC.NO.: 17476 (if applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 STURGIS LN,BARNSTABLE MA 026301419 Mt.TeL No.: *Per M.G.L.c.147,s.57-61,secunty work requires Department of Public Safety"5"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 Telephone No. PERMIT FEE:$50.00 bCCio� e(t ?(Ce t2/' _ s •- nn yy � a mmonmsa o f ma.machath Official Use Only Weparmanf of-tin�fraiW PermitNo.Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev• lro7) (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C (MEC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: It(p Lp 1 a City or Town of: YARMOUTH To the Inspec r of Wires: . By this application the Imdetsigned gives gptice of his • her'-tenon to pe , .. the h .'cal work described below. • . Location(Street&Number) G re C. Owner or Tenant �.�1� f Telephone No.gadmac ---v Owner's Address '-r�`—"'�—v `•,--,/j fls this permit in conj oa with a bmlding permit? Yes ❑ No R" (Check Appropriate Box) :III i PP Priare :I 1f Co t • Plurpose of Building C � Utility Authorization No. ' vj c.t L Existing Service t Amps VaalVolts Overhead reUnd grd Wt..,i`> New Service Amps / Volts Overhead ❑ No.of Meters �� ❑ Undgrd 0 No.of Meters i i_)N z lumber of Feeders and Am city N., 11.1 •< '? lion a s of Pro ed...Tical Wo • sa r7y�jj �� i�" __fin y" �� i J�4.�! --t - —" _ Completion of thefollawfng;table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of C Snsp.(Paddle)Fans • No.of Total Transformers EVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA - No.of Luminaires Swimming Pool Above ❑ In-d. ❑ BNatto.ofery Units Emergency Lighting t:rnd. No.of Receptacle Outlets No.of OR Burners FIRE ALARMS INo.of Zones No.of Switches t No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices • No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal Local❑Connection ❑ °t'er No.of Dryers Heating Appliances KW Security Systems:* No.ol Water No.of Devices or Equivalent No.ol No.of Heaters Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail(desired or as required by the Inspector of Wires. Estimated Value ole 'cal Work ' (When required by municipal policy.) Work to StartSt I$ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVE GE: 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 cov s in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INS • E aBOND 0 a71-IER 0 (Specify:) I certify, under e p•id penalties p.jar,th• e infonnatfon on this apps • n is true and complete FIRM N a V.\. ' i.. =�—r'' C./ LIC.NO.: wYw---- Licensee: % ta-, • ature LEC.NO.: �^L� (Ijapplfcabfe,a es n . e•{icens number line.) Bus.Tel.No: e—_,-;... Address: t Alt.Tel.No.: _ J "Per M.G.L.c. 147,s.57-61,s 'ty work requires Department of Public Safety"S"License: Lic.No. • — ,4, — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent t Owner/Agent j Signature Telephone No. I PERMIT FEE:$