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Home My WebLink AboutBLDE-19-002320 (C). Commonwealth of Official Use Only 1 \ Massachusetts Permit No. BLDE-19-002320 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 (PLEA SE PRINT IN INK OR TYPE ALL INFORMATION) Date:10/18/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives nottce of his or her intention to perform the electrical work described below. Location(Street&Number) 7 ANASTASIA RD Owner or Tenant QUINTILIANI EVELYN R TR Telephone No. Owner's Address QUINTILIANI INVESTMENT TRUST, 10 ROCKLAND ST,NEWTON,MA 02158-1411 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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&replace switches&receptacles. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei: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 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 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: NICHOLAS MCELROY Licensee: NICHOLAS MCELROY Signature LIC.NO.: 53797 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 Blackthorn Path,Forestdale MA undefined 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:$50.00 j I8 re__- J V rya Official Use Only 1 Lnommonwaa o`r,)aaeac�iaaafte c� cc77 ' X31! fA 1Jepartment of-lire-Cervices Permit No. tatrie ,d Occupancy and Fee Checked ---eke 'y`t BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) "� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),5't7 CMR 12.00 (PLEASE PRINT IN INK OR TYT�ALL INFORMATION) Date: ID/1/0 V City or Town of: ' o n cy. .. To the Inspector of Wires: By this application the undersigned gives notice�of his or her intention to perform the electrical work described below. Location(Street&Number) 1 Tvv 0N,s4oA s, r (Z..t.) , Owner or Tenant Do (-trim. GAA niiIm ) r Telephone No. CI7$- 2661-t1Y)_] Owner's Address • Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) , Purpose of Building Utility Authorization No. Existing Service 1 Eo Amps Z111 Volts Overhead,/ Undgrd❑ No.of Meters I ' New Service 1 Ue Amps 2"'/ Volts Overhead rLfJ Undgrd❑ No.of Meters T_ Number of Feeders and Ampacity Location and Nature of1Proposed Electrical Work: R I nee, �f Elert ip,.I S-try-tryit ♦♦ -t. t.W OUcUe,ry.+rJ &tm4 tl Cal Srl Completion of the followingtable may be waived by the Inspector of Wires. l% P No.of Recessed Luminaires No.of Ceil.-Sns .(Paddle)Fans No.of Total Transformers KVA 0" No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above I In- � No.of Emergency Lighting grad. grnd. Battery Units •d No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and c Initiating Devices (� Ili No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices 1 ) No.of Waste sh users Heat Pump Number•Tons KW._ No.of Self-Contained rrU. P Totals: Detection/Alertin• Devices No.of Dishwashers Space/Area Heating KW Local 0 Monnection unicipal 0 Other C No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of,WaterV No.of No.of Data Wiring: jilfHeaters Signs Ballasts No.of Devices or Equivalent N .•H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring Y g No.of Devices or Equivalent ra L0-HER: 1 Attach additional detail if desired,or as required by the Inspector of Wires. s� ted Value of Electrical Work: (When required by municipal policy.) ea_Jl a k to Start: 1 b/! q//Q Inspections to be requested in accordance with MEC Rule 10,and upon completion. 1 L4N URANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless 1+`" the icensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The 1e v and rsigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. 1)4 ° CHECK ONE: INSURANCE 0. BOND 0 OTHER ❑ (Specify:) tiZ 'Ice )5,under the pains and penalties of perjum that the information on this application is true and complete. INAME: LIC.NO.: S37g70 Licensee: NIU. ("1.tilcoq Signature tit LIC.NO.: (lf applicable,enter"exempt:du the license number line) Bus.TeL No. SOV-S64' Address: I I S ()Orr c LI MKS in /46111 /lA Oa64 K AltTeL No.: Lt 4 r4 *Per M.C.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: 1 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. Owner/AgentPERMIT FEE:S JS 0 H SignatureturaTelephone No.