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Home My WebLink AboutE-18-3607 Commonwealth of Official Use Only fray ►KE-- 1955 Massachusetts Permit No. BLDE-18-003607 �+� 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:12/19/2017 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) 18 NICOLE AVE Owner or Tenant ROBIN PARKS Telephone No. Owner's Address 18 NICHOLE AVE,WEST YARMOUTH, MA 02673 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 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: boiler replacement(508-776-5305) 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 rnd. 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 ❑ 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 fdesired,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 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: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:87 AUDREYS LN,MARSTONS MLS MA 026481629 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:$50.00 `�4- er crti l-omrnen+ucclg pF�e.6sec�.uecL�J Oncisl Vse Only 7' r� Permit eco. 'OV Jho . e___ , 2cpermLnf e{_dire&raises 3 BOARD OF ARE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev. 1)07] • peeve blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK .411 work to be pe;Farmed in accordance wits the Massachusetts Electrical Code(MEC),$27 CMR I LH (PLEASE PRINT Thr NKORTYPE ALL INFORMATION) Date: 1ai7 City or Town of: YARMOUTH To the Insp_cro94/ r of Wires: . By this application the 1mdersgeed gives notice of his or her intention to perform the electical work described below. . Location (Street&Number) / Q,'/ ys a e-0 L� R 4. Owner'or Tenant Rome H ((P42kS Telephone No. Owner's Address ___________ Is this permit in conjtmction with a budding permit? Yes Purpose of Bmf img ❑ N0. ❑ (Check Appropriate Rot) Utility Authorization No. Ezisling Service ,tamps / Volts Overhead Q IIn igrd❑ No.of Meters _ Q i New Service _ Amps / Volts Overhead Und d ❑ °r ❑ Na.of Meters _ `'.1,t Number of Feeders and Amparity LS. E „ Location and Nato. re of Proposed Electrical Work: 14 r4 • I...$1 Camaleton of the foIIawbr?table may be trued try the Inspector of Wirer, U I1 No. of Recessed Lambsnei-esin INa of Cert-Susp.(Paddle)Fars • No.of Total W Transformers L,'VA O No. of Luminaire Ortie4 ICY�erators • 1;'VA ' INo.of Hot Tubs (t L- -,' No.of Lumfraires ISwis+�ming Pool Above In- Q No.of.tmerp=ry Lighting ^- ern/ &Tad. IBattervUnits No.of Receptacle Outlets . No.of Oil Burners IF=� fii.-4ELhZ5 No.of loner No.of Switches No. of Gas Eta-tars No.of Detection and lnitiatin=Devices No.of Ranges To Tons of Alerting Devices Ho. of Air Cond. No.of Waste Disposers -• Meat Puap I Number Tors ICFJ (N o,of Self-Contataed Totals: DetectionfAlertin,Dwlces No. of Dishwashers ISpaceJArea Heating KW ILocal Q Municipal 4 Connection 0 No.of Dryers Me=ting Appliances KW (Security Systems No. of Water No. of No.of Devices or Equivzlent Heaters . KW No.of Dzta Wiring Sins Ballasts No.of Devices or Equivalent No,Hydromassage Bathtohs No. of Motors Total HP Telecommunications Wiring; — Na of Devices or Equivalent O1abR Attach additional detail f derived or at required by the Inspector of Wires. Estimated Value of Electrical Work (Wh Work to Start: en required by municipal policy.) Inspections to be requested in accordance with NEC 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 it substantial equivalent The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCLOND ❑ OTHER 0 (Specify;) f certify, ander the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: LIC NO,: Licensee: s ( —a t..t.e &L.. Signature 0442e99(LI L._ LIG N0:a (If applicable, enter"exempt"in the license number line.) • Addresr.87l��.•Qr.., ! =Tiber •LAe • Bus.TeL No�_ J 'Per M.G.L.c. 147,5.57-61,securitywork requireso !�� Alt rei,No.:,S. 77'?6-Sz.s- OWNER'S INSURANCE Department of Public Safety"S" License: Lie.No. qCE WAIVER.: I am aware that the Licensee doer nor have the liability insurance coverage n� regtured by law. By my signature below,I hereby waive this requirement I am the(check one 0 owner o Owner/Agent ❑owner's z eae Signature Telephone No. PERMIT FEE: $