The URL can be used to link to this page

Home My WebLink AboutE-18-5169 Commonwealth of Official Use Only - tat AMassachusetts Permit No. BLDE-18-005169 Itsh BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 'Rev.I/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:3/21/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice otitis or her intention to perform the electrical work described below. Location(Street&Number) 64 KINGS CIRCUIT Owner or Tenant GREEN COMPANY INC Telephone No. _ Owner's Address 46 GLEN AVE,NEWTON, MA 02159-2066 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 ❑ Undgrd ❑ 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 HVAC 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 o In- o 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertine 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 Sipns Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eau ivalent 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: DANIEL J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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: $80.00 4l�f(f ` t4agw-4W4C C 'a4ppy ceMsrisvrtqu pacts arrays 73q 42,0 asers /21ts tce, 'co LiekelaMiVa. I ffeeivniorSecsntiroaaot_->7eA,5j I n//�J �r/ tner;armra&of rr/a46aa waist Use Only (� ea- Permit c•�' c7 [� No._ Q -S ��. _�I . CP¢rtmcnt o�.yirir Servic n • \\x"(11 Occupancy and Fee Checked BOARD OF Fl PREVENTION REGULATIONS I • v. 1/07] (leave blank) APPLICATION FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code r C),527 MR 12.0(1 (FLEASEPRThPT DV INK OR flTEAQflQ7 Date:a y City or Town of: YARMOUTH To the Inspector .f Pares: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • . Location (Street&Number) (, t( I'k-L a9 3 Cr .ccvt! Owner ox-Tenant )-.'c,h� a y r 06.,8o —vt. s7— Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (CheckAppropristeBox) Purpose of Ewldmg Utility Authorization No. iExisting Service— Amps / Volts Overhead 0. Undgrd 0 No.of Meters -- New Service _ Amps / Volts Overhead❑ Undgrd 0 No.of Meters _ 1-\1 Number of Feeders and Ampacity FLU° m Location and Nature of Proposed Electrical Work: td, i,n R�r ' 1e..e..�,.., ,,,..,715,-,.< FuR,.ae<.s s x �iT,. OCompletion of the forint/Mir,table may be waived by the Inspector of f-i",-ez IA c‘.1 I No.of Recessed Lumiaah-es 'No, of CeSi.Susp.(Paddle)Fans INo.of Total 0(� Transformers INA No.of Luminaire Outlet IND-of Hot Tubs 'Generators • 'CVA ' •' A.. • Na.of Luminaires 'Swimming pool Above �- BafierpUn�itr��Laguna: (� Arad. =rod. o I - . Na.of Receptacle Outlets . INo. of Oil Burners 'ETRE ALARMS INo.of Zones No.of Switches 'No.of Gas Burners (Na.of De.ecnoa and • Initiating Devices No.of Ranges (Na-of Air Cond. Tom` No.of Alerting Devices J Heat Pump Number Tons KW INo,of Self-Contained Totals: Detection/Alerting Devi No.of Waste Disposers ces No.of Dishwashers Space/Area Heating KW' Local biunicipal - ❑Connection Otfer No.of Dryers !Heating Appliancessr Security Systems:' No.of Water fCVJ No. of No.of Datao.ofDevices or Equivalent Heaters Signs Ballasts Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER t • Attach additional detail if desired or as required by the Irspecior of Wer. 1 , Estimated Value of Electrical Wort (When required by municipal policy.) Work to Start 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 cov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCF BOND 0 OTHER 0 (Specify.) I certify, under the pains and p • of perjury,that the information on this application is true and complete v ECRM NAME: LIC.NO.: Licensee:� ,,,j 17 , Pik ^ � �_ Signature dQ P LIC.NO.:a(o —, (If applicable, enter"¢empt"in the license member line.) � ✓ Bus.TeL No.. Address:Q)11v,L1.e7s Ln• aiLsjb+.3 .++. s J `Per M.G.L.c. 147,s.57-61,securitywork requiresAlt TeL No..SeS7 30s Department of Public Safety"S"License: Lie.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 owners agent t Owner/Agent Signature Telephone No. ! PERMIT FEE: $