The URL can be used to link to this page

Home My WebLink AboutBLDE-19-001164 Commonwealth of Official Use Only atE`. Massachusetts Permit No. BLDE-19-001164 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev.l/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:8/27/2018 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 electrrCa or scribed jselgw. Location(Street&Number) 53 GENEVA RD 'AV Owner or Tenant KELLY JOSEPH B Telephone No. Owner's Address 164 ELM ST,NO ATTLEBORO,MA 02760 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Final inspection to close out expired permit. Completion of the following table may be waived by the Inspectotof 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 Above. 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 KW No.of No.of Data Wiring: Heaters Stens 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: EDWARD M LYNCH Licensee: Edward M Lynch Signature LIC.NO.: 35609 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 Mt.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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 , 1 ammotuna&of Maam ciae.lit �Off]iciiall Use Ii( • V, T . 7 �s Permit No. L-1 '( — L 1G4 -------- `4...: �`v17 ��/�`\ , .ri- sParfinenf o� Yirr Jsroice7 ' V� T(- : BOARD OF FIRE PREVENTION REGULATIONS ev. 1/0nryand Fee Checked �. I�7] (leave blank) APPLICATION FOR:PERMIT TO PERFORM EL CTR CAL WORK All work to be performed in accordance with the Massachusetts Electrical Com 4 C),527,sir .1)0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI019 Date: y , J City or Town of: YARMOUTH r ' B this To the In -�ector o ' ties: By application the undersign . s no,: a of his or her int `:.. to rm the a ctrical . .rk described below. Location(Street&Numbed , "j Alf , �7j gr Owner'or Tenant ( 9 Telephone No. Owner's Address 5q al 1' e II 1 Is this permit in conjunc9in with a ng permit? Yes No idi u 0 (Check Appropriate Box) Purpose of Bonding ft2(2- Utility Authorization No. Existing Service_ Amps / Volts Overhead 0 Und gid❑ No.of Meters _ New Service __ Amps / Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity -- C^ fits!, Loocationan Nitar of Pr osed Ele ca(l/woo,/rrk: 4 a 146' If laj/ II' ! 0r-1.. '_( ` Ca Li..... the , . t•.i. m, , 4, VVV ,fi for o W- . . ‘J.-1 No.of Recessed Luminaires No.of Cern.-Snsp.(Paddle)Fans "o.of To K. Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA i., No.of Luminaires Swimming Pool Above 0 In- No.�l mergenry Lighting 0 z grad gmd Battery Units W m g NO.of Receptacle Outlets No.of On Burners FIRE ALARMS )No.of Zones NC NNo.of Switches No.of Gas Burners o.of Detection and r Fp: No,of Ranges No.of Air Cond. Total Initiating Devices W o Tons No.of Alerting Devices V = i No,of Waste Disposers HeaTotalap'Number ITons I KW No.ofSelf-Contained Q p Detection/Alerting Devices W Vo.of Dishwashers Space/Area Heating KW' Local Municipal 1 C4 tn o.of Dryers Heating Appliances y Security Systems:*Systemssti*onother r o.o Water No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Sips Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional derail if desired or as required by the Inspector of Wires. Estimated Value .1 ectric.l W.rk: (When required by municipal policy.) Work to Start , pZ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C a E' G Unless waived by the owner,no permit for the performance of electrical work may issue unless • the licensee provi.es pr..f 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 0 OTHER 0 (Specify:) I cernfy,under the pains andl{tn`atties ofperjary,that the information on this application is nue and complete, FIRM NA t ': LIC.NO.: Licensee: _40 4 N 1 SignatureC r (Ifapplieabf ery+��'ec t/'r [IX�ie .4 numb-. line.1�, { �IiIC.NO.: O� Address: y i(./a f / ,n t ti l,j/2,10 ��/ us.Tel.No.• j 'Per M.G.L.a 147,s.57 61,secur work `f S Li y Alt.Tel.No.Vl� 79 security requires D artmrnt of Pu li Sa ety' Li core: Lie.No. — OWNER'S INSURANCE WAIVER: I am aware th the Licensee does not have the liability insurance coverage normally irequired by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent i Owner/Agent d Signature Telephone No. ( PERMIT FEE: $ S(7