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Home My WebLink AboutE-19-1133 ' Commonwealth of Official Use Only op �• ;,, Massachusetts Permit No. BLDE-19-001133 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/07) 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:8/24/2018 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) 31 SPRINGER LN Owner or Tenant SPITZER WILLIAM F Telephone No. Owner's Address SPITZER ANNETTE M,281 VEGA ROAD,MARLBORO, MA 01752 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 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 ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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 0 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 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: Gary L Gordon Licensee: Gary L Gordon Signature LIC.NO.: 15290 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR,DENNIS MA 026382234 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 S(2-f-t( (e • air l.ommpnroca1t o�c7 ¢6a��oai< clti UsSOnlyf�' �j . Zeparfincnf 1 giro...7crvicee .Permit No. 1 ' JJ riff- ' BOARD OF ARE PREVENTION REGULATIONS ev. 1/07) (l Fee Checked sd� ev. 1/07] (leave blank) ----- APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK 6 / All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 ClR 12.D0 //�(/—"j (PLEASEPRINT ININ OR TYPE ALLINFORM4TT0N) Date: 'rAa&/ ix'` / City or Town of: YARMOUTH To the Inspect r of Wires: r (,J r . By this application the Etndersigaed gives notice of his or her intention to perform the electrical work described below. 1 Location(Street&Number) 3 1n J r/,dM1/(//�_ I Owaer'orTenant WILL/ 9?JTZ£r? TeIephoneNo. „ _S Owner's Address / Is this permit in conjunction wi a 6 ;permit? Sd. Yes ❑ No �7 (Check Appropriate Box) 7 Purpose of Building CIA". Utility AuthorizationANo. Existing Service//l0 Amps/„Zei 0%Volts Overhead Undgrd❑ No.of Meters 0 ._i New Service Amps / Volts Overhead Undgrd 0 No.of Meters �`— _ Lu ` w Number of Feeders and Ampacity W f 2P aUe€41 A /.�� 2�Q�P • > m C Location and Nature of Proposed Electrical Work: r�s-L//��G7 '. 7" e Sell t / a r`t/ IVY/ W - --- - _ - Completion of the followinz table may be waived by the Inspector ofWi rr. V = i No.of Recessed Luminaires INo.of Cet1-Sasp.(Paddle)Faas No.of Tot Transformers KVA U jJ ¢ o No. of Luminaire Outlets INo.of Hot Tabs Generators • KVA ' 5 ;. . m m • No. of Luminaires (Swimming Pool Above ❑ In- 0 No. air v Units cy Laghung - arad. crud. IBattervIIaits No. of Receptacle Outlet No.of Oil Burners 'FIRE ALARMS INo.of Zones No.of Switches No,of Gas Burners -• • Na of Detection and • Initiating Devices No.of Ranges INa of Air Cont To -tal Tons INC.of Alerting Devices No.of Waste Disposers Aeat Pump Number Totts KW {{No,of Self-Contained - Totals:I I I_ 1Detectio&AlertineDevices No.of DishwashersSpace/Area Heating KW (Heating Appliances Local Municipal ❑Connection 0 Other No.of Dryers Security Systems:• ® No.of Water Noof No.of Datallo`. irinof Devices or Equivalent Heaters Sits. Ballasts VNo.of Devices or Equivalent k No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. si Estimated Value of Ec Work 27X (When required by municipal policy.) Work to Start c242-i5" Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RfiGE: Unless waived by the owner,no permit for the performance of electrical work may issue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent -mess 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) ta I certify,under the pains and penalties o perju,, the informatio on this eppffcatfon is true and complete. >�� t FIRM NAME: (5 g%✓,p e 4' �p ,q4 /e- a" LIC.NO.: ��-2� f Licensee:pSignature a LIC.NOi� Z _C // (If applicable, enter exempt"i the license numb r lin Bus.TeL No: Address: Z �e/,j.2Jf�if �//e r Alt Tel.No / j "Per M.G.Le.c. 147,s.57-61,s unity ork requires Department of Public Safety"S"License: Lic.No. ;-,-t OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. m Owner/Agent Signature Telephone No. I PERMIT FEE: $