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Home My WebLink AboutBLDE-19-002262 Commonwealth of Official Use Only �a. Massachusetts Permit No. BLDE-19-002262 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked £Rev.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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/17/2018 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) 9 AHAB RD Owner or Tenant LEAHY DOREEN Telephone No. Owner's Address LEAHY DAVID A,PO BOX 632,YARMOUTH PORT, MA 02675 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: Replace exterior service&upgrade grounding. 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- CINo.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 lnitiatine 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/Alertint 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 Siam Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP • Telecommunications Wiring: No.of Devices or Equivalent OTifER: Attach additional detail rfdesired,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: Jeffrey T Foss Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD.W YARMOUTH MA 026733543 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 e23D c 1a f t 9/it ' `` _ (-ommnnweald o`iilassac�rwetl! Official Use Only _ `-I\ „Y' . l 4 2-7`t/D' 2-i �l .elk lk .r� I-r Permit No. I{Y- :_.asn ThePartmenl o`7in service t• b Occupancy and Fee Checked 4, BOARD OF FIRE PREVENTION REGULATIONS [Rev. I/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ),527 R 12.0 ,„ / (PLEASE PRINT IN INK OR TYPE L ORMA IOf�) Date: �O i QS/ City or Town of: �ARQ(fit/ To the Inspector f{�iire�: By this application the undersigned gives rice off is op• r ntention jerform the ellectric work described below. ( Location(Street& NumberA ��j t // I 7 Owner or Tenant /,II - , s Telephone No.1&711f-05 N 60- - NOwner's Address 5 i P Is WI permit in conjunction with a building permit? Yes ❑ No, (Check Appropriate Box) 0 ' ur4 se of Building Utility AuthorizationAAAA""""' No. 1 I �7 / '1`I i rist ng Service it0 Amps lAO / 2 VOVolts Overhead Undgrd 0 No.of Meters 1 ��' r I "�11 �{� f s `� ew. ervice U V Amps po l a l" V i s Overhead Undgrd 9 No.of Meters (.L! cc:- I.Vimiber of Feeders and Ampacity 0 es y t (i 3 $ ion and Nature of Proposed Electrical Work: di(��'d ` Wie �,�,T 12.1 L'DI fPf�ht $d4!er a t -�/rb c/ /641. r4" _____i_, > Completion of the following table may be waived by the Inspector of Wires. t....-----No.- f 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 ❑ In- ❑ No.01-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. Tonal No.of Alerting Devices V No.of Waste Disposers Hest Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices ^ Municipal V No.of Dishwashers Space/Area Healing KW Local❑ Connection ❑ Other `,` No.of Dryers Heating Appliances KW Security Systems:' \ No.of Devices or Equivalent V\ No.of Water No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent ' No.Hydromassage Bathtubs No.of Motors Total IIP 'Telecommunications N .ofDeicor Wiring: No.of Devices Equivalent �j OTIIER: Attach additional detail if desired.or as required by the Inspector of Wires. Z Estimated Value of Elec cal Work• (When required by municipal policy.) Work to Start: D Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV E: 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 ermit issuing offices CHECK ONE: INSURANCE* BOND ❑ OTHER 0 (Specify:) G� ``'�P ,vs ii�� I certify,under the pains and a hies of perjury,that the information on this pp:cation is true and complete. FIRM NAME: p LIC.NO.: LLLsssy �/� Licensee: a`t°,fi/!e/ 7IA., Signature _✓4 ' iy/d LW.NO.: - �;�`�/ `` , (If applicable,"'lempr'•i (twit e numb ne. / p Bus.Tel No.• _ i�r//• Address: s////i U Jt/ KB w/y�n/��f�� p�j Alt.Tel.No.: r i • �9 I-7 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 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)❑owner 0 owner's agent Owner/Agent � I PERMIT FEE: $ '�U Signature Telephone No.