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Home My WebLink AboutBLDE-19-001514 A 0. Commonwealth of Official Use Only afMassachusetts Permit No. BLDE-19-001514 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ,IRev.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:9/13/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of ms or her intention to perform the electrical work described below. Location(Street&Number) 33 JANICE RD Owner or Tenant MACDONALD MARGARET M Telephone No. Owner's Address 33 JANICE RD,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 O 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 oil burner. 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 ❑ ln- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners 1 FIRE ALARMS I 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 ❑ 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 U.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: IAN B JACKSON Licensee: Ian B Jackson Signature LTC.NO.: 39860 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:273 MAIN ST, HARWICH MA 026452467 Alt.TeL No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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 cej a2fi31"/9 ,t' . A C.ommonmean o`///assachsdeus .4 Official Use Only Permit No.o ..7{H Sendaiis 131-r Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] (leave blank) APPLICATION FORPERMIT 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: a t 1t% CS 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) 33 S-a,11\tG2 i(t'_oA-IS. Owner orTenant Telephone Owner's Address M��/ � �� bo � No. Z3 Onte e anA-1s 59.Jfl Vet,no Is this permit in conjunction with a building permit? Yes ❑ No E1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd } 0 NO.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 3 3 „Tea^ta.. Itc'itk+, W 12F riga, v i 1 bt/2rv,f_d_ • Completion of thefollowin table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In-arnd. BNo,oflmergency Lighting grnattery 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 Mr Cond, Too No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' LocalMunicipal ❑ Connection ❑ er No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water No.of Heaters KWNo.of Data Wiring; 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: 25Z) (When required by municipal policy.) Work to Start: 47142.-a3 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (BOND 0 OTHER 0 (Specify:) I cernJy, under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: LW.NO.: Licensee: .ip n i'' C(-ce_m.Son I Signature af .N . Q LIC.NO.: F_39Rt p applicable,enter"exempt"in the license number line.) Bus.Tel.No.• Address: J 'Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance overage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/Agent d Signature Telephone No. . I PERMIT FEE: $ I