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Home My WebLink AboutBLDE-19-001095 ) CommonweaIth of Official Use Only f Massachusetts Permit No. BLDE-19-001095 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.l/071 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:8/22/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the electrical work described below. Location(Street&Number) 153 CAPT BACON RD Owner or Tenant TAYLOR JONATHAN T TRS Telep,' • . • ' .o.,, • J Owner's Address TAYLOR HELEN E TRS, 153 CAPT BACON RD,SOUTH YARMOUTH,MA 0 •• 1 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) /A Purpose of Building Utility Authorizati, 1 No. 2293024 _. P t Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters � 0 J� New Service Amps Volts Overhead ❑ Undgrd ■ No.of Meters [1/ j't,'• Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wire 3 season room&upgrade service. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans 1 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 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 3 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 Ca 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. I CHECK ONE:INSURANCE El BOND 0 OTHER 0 (Specify:) 1 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 LW.NO.: 14065 (If applicable,enter"exempt"in the license number line.) s Bus.Tel.No.: Address:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 Mt.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:$75.00 .Rt 3taS • V 4r.i n� • rryye� ' y� �amnwnmsa of rr/assac/wsrfls _ Official Use Only `, .1,9= c� c7 Serviced sit G /� Q N" _ = zapartmanf of"ire Se vices , No. li�"I Q l • "lk- Occupancy and Fee Checked • - = BOARD OF FIRE PREVENTION REGULATIONS . 1/07) • (leave blank) • • APPLICATION FOR,PERMIT TO PERFORM EL CTRICAL WORK tAll work to be performed in accordance with the Massachusetts Electrical Code I 527 1 00 (N (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: € (a J V City or Town of: YARMOUTH To the I -'ector Wires: CI ' ) t.. 3y this application the tinders.igned gives notice of his or her' ention to rfo a electrical work described below. X\17.--�- Pe WW J_0 • :oration(Street&Number) ��j 3 Cep ct f / �c O e \ o CV "'- tie Owner or Tenant J p �G-7 �� f Telephone No. e t�ie w Owner's Address Sq M e / p �8�t9 7d�77 W '1 eel O s this permit in conjunction with a building permit? Yes Er---No 0 (Check Appropriate Box) V y = i 'Purpose of Building ge 5, Utility Authorization No. a6/9,3009 4( W J¢ o e zisting Service Ito Amps /0)0 /?I(O Volts Overhead [WTUndgrd 0 No.of Meters f. EL m`bew Service /DD Amps Lip /a'j'O Volts Overhead 0' Undgrd 0 No.of Meters ( Number of Feeders and Ampacity (-2- Joe 67.q'S Location and N re of Proposed Electrical Work: 2 vko Chan. ar .f, ro 3Oc.'Kr- W?rr/o4( /cP 1>e/6 3Segj00( • Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cert-Susp.(Paddle)Fans NTr, s Total / Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above 0 In- No.of Emergency Lighting - /_ end_ rn gd. 0 Battery Units & No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches 3No.of Detection and No.of Gas Burners Initiating Devices ` f No.of Ranges No.of Air Cond. TonNo.of Alerting Devices No.of Waste Disposers Hest Pump Number (Tons IKW No,of Self Contained Totals: Detection/Alertiae Devices No.of Dishwashers Space/Area HeatingKW' Municipal - LocalO Connection 0 Oiwr No.of Dryers Heating Appliances KWSecurity Systems:" v No.of Water No.of Devices or Equivalent , II Heaters KW No.of No.of Data Wiring: ` Signs Ballasts No.of Devices or Equivalent J, No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: L� Na of Devices or Equivalent OTHER: `/, - � Sb Attach additional derail ifderired or as required by the Inspector of Wires. Estimated Value of Elec cal Work ,,,,e, (When required by municipal policy.) 1 Work to Start: 07 i- Inspections to be requested in accordance with MEC Rule 10,and \ upon completion INSURANCE VE GE: 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: INSURANCEND 0 OTHER 0 (Specify:) i/ �( Q I terrify,under the ,ains an"pe • .. s , perjury,that the information on this applicatio, is true and completeI et 0�c A" FIRM NAME: ail e2.G • I --, - I ♦ LIC.NO.: Licensee: it, -I - Signator lial.(� " v •'v LIC.NO.:a to e. ._ f eable, O"900.. fn 9 4 11 errus�berl r - � ae7� Bus.Tel.No.: 1- Address: plica r O� /t/ //nn��fp7 � J `Per M.G.L.c. 147,s.57-61,security work requires Dep of Public Safety"S"License: Alt.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. 1 am the(check one)0 owner 0 owner's agent i Owner/Agent j Signature Telephone No. I PERMIT FEE:$ '7 s-