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Home My WebLink AboutBLDE-19-002498 d y 411 Commonwealth of offioialUseonly • E �, Massachusetts Permit No. BLDE-19-002498 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:10/29/2018 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) 360 LONG POND DR Owner or Tenant LOUD SHIRLEY L TR Telephone No. Owner's Address THE 360 LONG POND DR RLTY TRUST,360 LONG POND DR, SOUTH YARMOUTH, MA 02664-4243 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Septic pump&alarm. 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 1 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 lay No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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:) I certify,under the pains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: BRIAN A SMITH Licensee: Brian A Smith Signature LTC.NO.: 24307 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 GELDING CIR,BARNSTABLE MA 026301503 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 Cei.j (OP 51 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK 4 All work to be performed in accordance with the Massachusetts Electrical Code,(MEC),527 CMR 12.00 ti. , (OFFICE lR�t V E D TOWN OF YARMOUTH By wrrxµ¢r Fee: $ OCT 26 2018 n� PERMITNO. L` BUILDING DEPARTMENT — ay (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: C$ .i t o To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perfo he electrical work described below. Dn Location(Street&Number) .. a /Q/c/ Ala,v1c /01/7/0/4 C' Clt±., Owner or Tenant €34,P/fy 07)21 Telephone No. Owner's Address < s. / f ..,� Is this permit in conjunction with a building permit? El Yes LN"No (Check Appropriate Box) Purpose of Building gas- Utility Authorization No. Existing Service.,70 Amps /o?0 /40 Volts Overhead❑ Undgrd❑ No. of Meters / New Service _ Amps 1 Volts Overhead❑ Undgrd❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed electrical Work: itfien76 cf 4541G clxCil2/ 9 Completion of the following table may be waived by the Inspector of Wires No. of Total No. of Recessed Fixtures No. of Ceil:Susp.(Paddle)Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA AboveIn- No.of Emergency Lighting No. of Lighting Fixtures Swimming Pool grad. ❑ grad. ❑ Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No.of Gas Burners Initiating Devices Total No. of Ranges No. of Air Cond. Tons No. of Alerting Devices Heat Pump lilcumber Tons KW No. of Self-Contained No. of Waste Disposers Totals: n Detection/Alerting Devices Municipal No. of Dishwashers Space/Area Heating KW Local Q Connection El Other Seosyst vice:No.of Dryers HeatingAppliances KWN .of Devices or Equipvalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP ya Telecommunications el No of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may be issued 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 he permit issuing office. CHECK ONE: INSURANCE BOND El OTHERQ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the .:'n and pe all:s of .e ' ,that the information o' is a.. ':Prion is true and complete. ��//c�,�, FIRM NAME: /!I /A6 ea LIC. NO. Evxx79 17. Licensee: twit Signatur-/r - jpeameir LIC. NO. (If applicable enter"exem.t" in the license n mber li - , Bus.Tel. No.: ,52-if7.17 gene. Address• "Lid / . /C £#akt #O' 7/ Alt. Tel. 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 O owner's agent.Q Owner/Agent Signature Telephone No. [Rev.04/00]