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Home My WebLink AboutBLDE-19-001720 or Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-19-001720 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:9/21/2018 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) 14 LAKELAND AVE Owner or Tenant SLAMA GEORGE R Telephone No. Owner's Address DREW MARGARET B, BOX 523,SOUTH YARMOUTH,MA 02664 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 0 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: Install dimmers,lights,&TV's. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 8 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 0 fn- 12No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 2 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 ❑ 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 IIP 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 terrify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: MARK B KIEFER Licensee: Mark B Kiefer Signature LIC.NO.: 26093 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 GRASSY POND DR,DENNIS MA 026382515 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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 J n/J tyy �- l.omnwnarfa of„/amactt! _ Of6 ' Use On ,,,,L, Nn 1JrPartmrrtl o� ttrr S' Permit No. naiad '�'�- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07) (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 ALL INFORMATION) Date: q - oZ/- ',pi it 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) 1 1 . L4 gr. ( 14-up Ave Owner'or Tenant Sed,c P e 5'LA m 4 Telephone No. f cj i lf Owner's Address ]TM /1 Is this permit in conjunction with a building permit? Yes 0 No. R (Check Appropriate Box) Purpose of Building Utility Authorization No. c Existing Service_ Amps / Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps / Volts Overhead Undgrd No.of Meters Number of Feeders and Ampacity and Nature of Proposed Electrical Work: a . N s i_ '. sepp a 'S �'-b w Ari Q f�LI \ W m D . ' se... N f f3,2Aa4icaj o I completion oJthefollowin�tabfe may be waived by the lmpecior oJWiret. c�N. f .ecessed Luminaires Q No.of Cert.-Sasp.(Paddle)Fans Tranf >NA V Transformers LI.1 cv Martel uminaire Outlets No.of Hot Tubs Generators ICVA V V '1 Nd t uminaires Swimming Pool Above Q In- No.of Emergency fighting e� Kind. cued. Q Battery Units IU NhJiff eceptacle Outlets O` No.of Oil Burners FIRE ALARMS INo.of Zones t. No7ot witches No.of Gas Burners No.of Detection and • • Initiating Devices No.of Ranges No.of Air Cond. Too No.of Alerting Devices • No.of Waste Disposers Heat Pump iNumber ITons I KW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' 1, ❑Municipal Connection El Wier No.of Dryers HeatingIN Appliances V 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.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Waring: No of Devices or Equivalent OTHER: _ Attach additional detail ifdesired or at required by the Inspector of Wirer. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: g.AD att. 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 2- BOND 0 OTHER Q (Specify:) I certify, under the pains and p nalties i of er/ury,that the information on this application is true and complete. FIRM NAME: d 1 ,4,Lj Kjec ac Art/ LIC.NO.: Licensee: at)//{ LIC Kl e le-bite Signature LIC.NO.: T616 3 Afd rens: . enter"gepwt in the license ria r line) Bus.Tel.No... Address: � (•y 1� SS �,N � � ,�,Q� k� �y¢ Alt.Tel.No.: j Per M.G.L.c. 147,s.57-61,securiwork requires Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally i required by law. By my signature below,I hereby waive this requirement I am the(check one)Q owner 0 owner's agent r Owner/Agent Signature Telephone No. I PERMIT FEE:$ fj