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Home My WebLink AboutBLDE-18-007391 Olk '—• czki.54 Or Commonwealth of Official Use Only Massachusetts Permit No. BLDE-18-007391 ��- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 'Rev.!/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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:6/28/2018 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) 161 EILEEN ST Owner or Tenant HANLEY LORRAINE M Telephone No. Owner's Address 17 MIDDLE ST,WATERTOWN,MA 02472 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 ❑ 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: Install 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- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.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 ❑ Municipal ❑ 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 ❑ BOND ❑ OTHER ❑ (Specify:) I terrify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$75.00 Ciard(Q'Cietk(A9I-e-ir 7144° 6)6, Its .� - l cy _� - l.ommonmea/o`rr/adsacka.t s ...: {{•--O�fficial Use Only CP c 2epartnent of ire..ervicea Permit No. C(r �! t 3 -ill ' Occupancy and Fee Checked 1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALLINFORMATION) Date: 4 - 2 7 _/F City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pndeisigned gives notice of his or her intention to perform the electrical work described below. ) LLocation(Street&Number) C6 / E/LFG /C/ ..5-1. PA/Z M�17,-/Pp2!— OwnerorTenant GR,A�NC f/A/VLC� Telephone No.6/7-5/4F-//09 — �I�)li Owner's Address /‘/ /:::://-F_t</C1 57 YA2/Lfr'eCri./ O/ZT Is this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) 'urn se of Building Utility Authorization No,20/$ A4062720 t,Y.:' A axis ng Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters W �\ m ';L1 ervice Amps / Volts Overhead❑ Undgrd 0 Ne.of Meters N Camper of Feeders and Ampacity as �catfon and Nature of Proposed Electrical Work: it 1 h'S z ____..0_ ....r = :. 1 nCompletion of the folowintiable may be waived by the Inspector of(Ares. I ill tri.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA lgo-oi Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires �'yhr"t'7/5 - Sq, ung pool Above ❑ In- No,of k,mergency Lighting t-/.4"fT grad. grnd. ❑ Battery Units No.of Receptacle Outlets / No.of Oil Burners FIRE ALARMS INo.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 Municipal Connection ❑ °lb?r 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.Hydromass age 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 World (When required by municipal policy.) Work to Start:.7".2.1"/3' 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 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: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable, enter"exempt"in the license number line.) Bus.Tel.No.• Address: j *Per M.G.L. c. 147,s.57-61.securiwork Alt.Tel.No.: ty rc quires Department of Public Safety"S"License: Lie. o. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insu ce coverage normally required by I B my signs below I hereby waive this requirement. I am the(check one) owner 0 owner's agent t Owner/Ager x� Signature (l _ Telephone No.6/ 5-7/q al 4711 PERMIT FEE: $ ..lig---11C--- _ --11C/