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Home My WebLink AboutBLDE-19-001503 w. \i Commonwealth of Official Use Only 1a Massachusetts Permit No. BLDE-19-001503 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked VRev.l/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:9/12/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice tit his or her intention to perform the electrical work described below. , Location(Street&Number) 4 STRATFORD LN Owner or Tenant OBRIEN VIRGINIA C Telephone No. '� r +e' fir' Owner's Address 4 STRATFORD LN,YARMOUTH PORT, MA 02675-1545 V v Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) ��/ 7 Purpose of Building Utility Authorization No. 2z 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: Replace service. 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 0 In- 1:1No.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 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 I Number Tons J 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 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 fdesired,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: Eli S Ryder Licensee: Eli S Ryder Signature LIC.NO.: 39761 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:610 PLYMOUTH ST,MIDDLEBORO MA 023462902 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 0)0 cO cI' ,/'s et- JJj n/J • l.anvnonweald o/e�M' assac ti Official Use On r(�� if. 1JrParimrnl ol,ytrr • jPetNo. lfl L`` ..1 'v _ Service! -1=� Occupancy and Fee Checked SD•� 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: 9-72- /H Cityor Town of: YARMOUTH To the Inspector of Wires: Z By this application the pndetsigned gives nod of is r her intention to rform the electrical work described below. ) 7' fnd� c J o`f't Location(Street&Nummber N j.5 Owner'orTenant Ko4eJ Telephone No. w Owner's Address W ei d Is this permit in conjunction/with building permit? Yes 0 No ❑�(Check Appropriate Box) Purpose of Building �f4 /M,, J .�(, Utility Authorization No. .r Existing Service//4 Amps /3>' /,2/p Volts) Overhead 0 Undgrd Er No.of Meters / CC ew Service l®O Amps , fr /2y'vol Overhead❑ Undgrd Q� No.of Meters Number of Feeders and Ampacity 7 I/ nj • Location and Nature of Proposed Electrical Work: / l� d� rcnr.! 4 de'...- CLQ �ICHe"��1.� en/4Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires Na.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 OH Burners FIRE ALARMS !No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices To No.of Ranges No.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump Number Tons KW No.of Selt-Contained Totals:I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW LocalMunicipal Q Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:" - S No.of Water No.of Devices or Equivalent No.of No.of ki Heaters Data .ofDe Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: W Na of Devices or Equivalent OTHER: - •1 Estimated Vallee f Electrical W o Attach additional detail it-desires(or as required by the Inspector of Wires. Value" 3��9 O� (When required by municipal policy.) Work to Start: 1112/g 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. ICHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) I ten ,under the pgL tr and grn ofperjury,that the information on thio application is true and complete. FIRM NAME: �`/.r s' i G'< L'X'ct�� ' 1rnH �97c/ ( k Licensee: r'/J� ��LIC.NO.: Signature �/G �G� LiC.NO.: V (Ijapplicable, ntpr"esem the license ymbej�^ L Bus.Tel.No.kce.gee/ACCP Address: 6/2 infer.? / 1 .�"44r' Ai.9 a' Alt j Per M.G.L. c. 147,s.57/61,security work requires Department of Public Safety"5"License: Lic.No. ex OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent. c Owner/Agent _I Signature Telephone No. . I PERMIT FEE: $