E-19-1538 •
l 1�
Commonwealth of Official Use Only
® Massachusetts Permit No. BLDE-19-001538
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
IRev.1/07)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00
(PLEASEPRINT 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 his or her Intention to pertorm the electrical work described below.
Location(Street&Number) 6 JACQUELINE CIR
Owner or Tenant WEBB ANDREW C Telephone No.
Owner's Address LINGOS TATIANA I,200 HINCKLEY RD,MILTON,MA 02186-2853
Is this permit in conjunction with a building permit? Yes ❑ 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 ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity t
Location and Nature of Proposed Electrical Work: Install generator
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 1 KVA 12.5
-
No.of Luminaires Swimming Pool Ab0 In- No.of Emergency Lighting
grnove d. grnd. 1:1 No.
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 Number Tons 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 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:)
/certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: DAVID W SPRINGER
Licensee: David W Springer Signature LIC.NO.: 21170
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:70 Bishops Ter, Hyannis MA 026012106 Alt.Tel.No.:
,Per M.G.L.c. 147,s.57-61,secunty 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
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_ t,ommanwra of sr/wtaclfs Official Use I
- 09113 e
_ _ 25 parimeni oilire J Permit No.
� 11�� r rrvfus I� 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: l/1 3I 1 s
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) Cj RC Ur• 1;(Ne. c t C L3 'fry ri eU` "1
OwnerorTenant Drew Uttoto Telephone No.
Owner's Address
/ Is this permit in conjuncts n with a building permit? Yes ❑ No (Check Appropriate Box)
e..„3)
Purpose of Building (� (, 'tai Utility Authorization No.
Existing Service Amps / Volts Overhead❑, Undgrd❑ No.of Meters _
New Service Amps / Volts Overhead❑ Undgrd gr 0 No,of Meters
Number of Feeders and Ampaclty L `` r�"[,�
Q F.[, atlon and Nature of Proposed Electrical Work: Z.t K �1 C.U�•g S�q d J }d
iw !b� w
~ Compfetian of thejoflowing table maybe waived by the Inspector of Wirer.
> a of Recessed Luminaires No.of CeiL Snsp.(Paddle)Fans No.of Total
W Transformers KVA -
�' .of Luminaire Outlets No.of Hot Tubs Generators KVA
(7
V N of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting
W grnd grid. 0 Battery Units
i= .of Receptacle Outlets Na.of Oil Burners
1 FIRE ALARMS INo.of Zones
.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
•
No.of Waste Disposers Heat PumpNumber Tons W No.of Self-Contained
Totals:I "'�KDetection/AlertingDevices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating Appliances KVV 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 Wiring:
No of Devices or Equivalent
OTHER: _
Attach additional detail ifderired or as requtred by the Inspector of Wires.
Estimated Value of lectrical World 3/00 G,w (When required by municipal policy.)
Work to Start: IS 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 Si 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: Sp •1tk•GC• (, QC�^CC LIC.NO.: t l\70
Licensee: C>kst' 1 11),N OVIC Signature /1/43 ,_,\ I LIC.NO.: 13239
(Ijapplicable,enter"exempt"in the lieeksfnu�mber linB��{��,� Bus.Tel.No.. 6�434��3 q
Address: 7b �j app tt '"�
j `Per M.G.L. c. 147,s.57-61,security work requiresDepar�unr�of Public Safety"5"License: Alt LiTa No.
Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ormally
S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.,.....
s Owner/Agent
0.1 I PERMIT FEE: S I
Signature Telephone No.