The URL can be used to link to this page

Home My WebLink AboutE-19-1872 pr„:„...„ Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-001872 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:10/1/2018 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 electrical work described below. Location(Street&Number) 3 ALISON LN Owner or Tenant DUMAIS PAMELA M TR Telephone No. Owner's Address ALISON REALTY TRUST,3 ALISON LN,WEST YARMOUTH,MA 02673 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: Generator installation. -s`-�1. 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 t� No.of Luminaire Outlets No.of Hot Tubs Generators 1 KVA 14 s� No.of Luminaires Swimming Pool Above ❑ In- 1:1No.of Emergency Lighting X11 grd. grnd. Batters,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 C Initiative Devices No.of Ranges No.of Mr Cond. Total No.of Alerting Devices Ton. No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices , lb 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: Todd M Ellis Licensee: Todd M Ellis Signature LIC.NO.: 10331 Qfapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 FOX HOLW,PLYMOUTH MA 023607737 Mt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: OWNER'S LNSURANCE 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 (td 'cala'(e t_ . . �om . . O Use .,, 1aimed of yin� svrcetPPermit No. v _-l_ J(J Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. I/07j • (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: City or Town of: YARMOUTH To the Inspector of Wires: . By this application the pttdersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) ,3Abin ii In Owner'or Tenant () Ma/ pnMa/5 Telephone No. t0 if gay Owner's Address 3 A/L5nn in b rn1 Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) o nrpose of Building /t�ZY)0/A1t9 itUtilityAuthorization No. ao q Sbf' w w tilting Service Amps 1901 a0 Volts Overhead 0 Undgrd❑ No.of Meters 2 o ~ ew Service 0 Undgrd N rr Amps / Volts Overhead agrd 0 No,of Meters • o amber of Feeders and Ampadty oration and Nature of Proposed Electrical Work: /Who ke hk•y hey? d .473 o w e W Sn • Completion of the followin&table may be waived by the Inspector of Wires. rt �'m No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No.of Total Transformers KVA CV No.of Luminaire Outlets No.of Hot Tubs Generators INA No.of Luminaires Swimming pool Above ln- Nottery.or t Umergency l tgnuag ttrnd. arnd. 0 Banits - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons 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' Local Municipal - Connection 0 oma No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters No.of No.o[ 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 ifdesirec(or as required by the Inspector of Wires. 114 Estimated Value of Electrical Work: 'AM (When required by municipal policy.) Ne Work to Start yon Inspections to be requested in accordance with MEC Rule 10,and upon completion. eU 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 r undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE tf BOND 0 OTHER 0 (Specify;) ` !certify under the pains and penalties of perjury,that the information on this application Is true and complete. FIRM NAME: Obi e [I LIC.NO.:/(133�� / Licensee: J Signature t 4Y LW.NO.:ol/9NgA (If applicable,enter>rempti inOAlicense number line.) Bus.Tel.No.-7%!9.S it'.l„t7a Address. & PL�/D'O?mi' 0436(y ' j Per M.G.L.c. 147,s.57-61,securitywork requires License: Alt.Lic.TeL No.: OWNER'S INSURANCE WAIVER: I am aware that thea icensee does not have the liability insurance coverage normally required by law. B Owner/Agent y my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. Signature Telephone No. I PERMIT FEE: $ 1