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Home My WebLink AboutBLDE-19-002397 a• sl,, Commonwealth of Official Use Only `/Ai Massachusetts Permit No. BLDE-19-002397 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked fRev.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:10/22/2018 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) 172 CENTER ST Owner or Tenant GREENE PATRICIA ANN Telephone No, (� 5 Owner's Address PO BOX 286, CENTERVILLE,MA 02632-0286 ,�t� Q. 40 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Boxy' 'o '- 1 Purpose of Building Utility Authorization No. 2302697 �/ el 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 ❑ In- ❑ 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 ❑ 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 tf 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: Thomas J Madden Licensee: Thomas J Madden Signature LIC.NO.: 14065 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 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 N1a- 10frill e }Z ,_c0- /ci/vap d ewnnionivealth of PlassacLeetti lereUse Q/giy5 ?7 .1J C.11t 'G.`d` __a. s=� Permit No. apartment of.74,serviced y . . 7.-w BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev. 1/07) (leave blank) N. APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK N All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR I2.00 J (PLEASE PRINT ININKOR TYPE ALL INFORMATION) Date: v City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her�r.i,nCtention to perform the electrical work described below. . Location(Street&)>jo�r) f7a(Q ace J ' . VPmel'r- ea-67�' V Owner'orTenant v.jr reel(Q Canter � .t Telephone No. 3ba•gaS/' �lj Owner's Address m� �6 1�¢N I"<.rrUi Ile �4i oa t 3 a Is this permit in conjunctigp with a building permit? Yes 0 No [a'(Check Appropriate KPP Ptite Box) PZ .se of Building e Sr Utility Authorization No.j 34),X) 9 7 0 Rs.,ng Service (00 Amps Pao /9 YPVolts Overhead ,,.,/Und L'�! grd❑ No.of Meters , Ne5.w.:ervice MO Amps (10 /20 Volts Overhead❑ Una y�.� grd ❑ No,of Meters / r of Feeders and Ampacity _ go / / .► Ui 4P" ' !onl and Nature of Proposed Electrical Wry: n c - Se r ice 0— grcKcx 0- -fr J t!';Ar - 5 Completion of the following table may be waived by the Inspector of Wires. (e 'a0 Recessed LuminairesNo.of Cel.Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire OutletsNo.of Hot Tabs Generators KVA • No.of Luminaires Swimming Pool Above Battery iUnits No.of Receptacle Outlets No.of OH Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Barren No.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Ton 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 HeatingKW' Municipal Local 0 Connection D Other No.of Dryers Heating Appliances Kw Security Systems:" No.of Water No.ofNo.of Devices or Equivalent Heaters K' No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP telecommunications Wiring: Na of Devices or Equivalent OTHER: • (7��"•� Attach additional detail if desired or as required by the Inspector of WiresT Estimated Value of lec al Work d .7 `�• (When required by municipal policy.) Work to Start: Q a g Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue fatless 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 [ 36ND 0 OTHER 0 (Specify.) I cern)",under th ins frt penalties o erfuty, tie information on this application is true and eompies / FIRM NAME: ///4ct an.2 1 e G s9C 12 LIC.NO.:ff'IyDF�� Licensee: /p� / r I1 L Q^�( Signature If era lJ /4 IC.NO.ac`j (If applicable,niece" pt' in the icense numb ti e) Address: i-0 COS `- C� Jf�r�Q en--1-0 )Bus.Tel No.: J 'Per M.G.L. c. 147,s.57-61,security�ork requirest �aF Alt.Tel.No.:_� Department of Public Safety"S"License: Lie.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)0 owner 0 owner's agent t Owner/Agent Signature• Telephone No. I PERMIT FEE: $