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Home My WebLink AboutBLDE-19-1613 . ' • Commonwealth of Official Use Only a Massachusetts Permit No. BLDE-19-001613 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.l/071 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perforated in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:9/17/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of Ns or her intention to perform the electrical work described below. Location(Street&Number) 84 CAPT NOYES RD Owner or Tenant BERTINI BETTE Telephone No. Owner's Address 35 NONANTUM ST, BRIGHTON,MA 02135 Is this permit la conjunction with a building permit? Yes ❑ No 0 (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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate porch lights 8 add feed for fan. 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 ❑ In- o No.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 Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 ❑ BOND ❑ OTHER 0 (Specify) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: THOMAS P SULLIVAN Licensee: Thomas P Sullivan Signature LIC.NO.: 18182 (Ifapplicable,enter"exempt'in the license number line.) Bus.TeL No.: Address:71 WAQUOIT RD,COTUIT MA 026353517 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 r Fla._ 1o( c51i8 e.. r' '" Commonwealth o/Massachusetts Official Use Only '' t3 j5�111 — I1 `/P 3 rr ft ccyy� cc77 nf� Permit No. gE- ie la-- ; 1JePartmenf olJlra-Cervices c, .. L .. ;Uri Occupancy and Fee Checked .,. v BOARD OF FIRE PREVENTION REGULATIONS [Rev.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- 17— 1/4 City or Town of: Q (t n10(tHi To the Inspector of Wires: By this application the undersigned IvesLnotice of his or her intention to perform the electrical work described below. • C7 Location(Street&Number) CQ P eQ i13 N O i 7►i&S Owner or Tenant 'Pc o_E€-e 73 Q e tyl 1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building T(ppl]tyt�\ Utility Authorization No. Existing Service Amps V / Volts Overhead 0 Undgrd❑ No.of Meters INew Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters ( Number of Feeders and Ampacity LocationI and Nature of Proposed Electrical Work: ge 1oeGtI•t J... h{ l0 ¶bfe(. — J IQ—CA ei cepc1 Fnir cGti Completion of the followin• table may be waived by the Inspector of Wires. -��No of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Q - Transformers KVA IJ l No.of Luminaire Outlets No.of Hot Tubs Generators KVA 5 , o of Luminaires Swimming Pool Above ❑ In- ❑ No.of 1 mergency Lighting c.+ ,t grnd. grnd. Battery Units L1" To. )1'Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones V w Igo.of Switches No.of Gas Burners No. InDtand C\ nitiaatintionng Devices UJ vcn o. f Ranges No.of Air Cond. TotaTons No.of Alerting Devices J Ce Nb: f Waste Disposers Heat Pump Number Tons _ KW No.of Self-Contained ii Totals: — Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ Other C No.of Dryers heating Appliances ICVp Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Tom' Heaters Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP 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: a S'Q ' (When required by municipal policy.) Work to Start: 9 /t /e Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAG: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 [B'BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this a plication is true and complete FIRM NAME: TOM t.S(>LL/(/Q/(J 6/00512/44( �t^ �� LIC NO.: /92 117 Licensee: -T'tANtfee, Cilillu?,c Signature ��'^ LTC NO.:/^VOW (If applicable,enter"exempt"in the(cense number lir,,,,) '^A� Bus.Tel.No.. ` Address: -7/ (,(/et t Utt2 t� c( (-ei b� Y vvPI Alt Tel.No.: en?SO-Ctn/ *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 IS. By my signature below,I hereby waive this requirement. I am the(check one)❑owner 0 owner's agent. Owner/Agent I PERMIT FEE:$ 15-' Signature Telephone No.