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Home My WebLink AboutBLDE-19-002718 1 ' �`' Official Use Only or r Commonwealth of t� +ri' Massachusetts Permit No. BLDE-19-002718 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:11/5/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomi ` ,icetncal wo t�.'tie below Location(Street&Number) 42 SCALLOP RD bei-10 1 Owner or Tenant MAHER DAVID L Telephone No. Owner's Address MAHER MARILYN J,400 CAPITOL PARK AVE#202,SALT LAKE CITY, UT 84103 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: Security&fire system. Completion of the following table may be waived by the Inspector of Wires. r No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire OutletsNo.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o 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 5 Initiatine 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* 9 No.of Devices or Equivalent No.of Water Kµ, No.of No.of Data Wiring: Heaters Siens 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 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 Lee Licensee: Thomas J Lee Signature LIC.NO.: 172 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 CAPTIVA RD,WALPOLE MA 020812042 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 i / Telephone No. PERMIT FEE:$45.00 ate-4 1tfCe/ fa i� , .,1 + -., 97753S/Ja iis/osa-7 • \, . Commonwealth all;llamado-48th OOffiJ�Quse�l 1 t� e Merriment PeffiitNo. Com{ ] 7-- -.0,F- la I_ Merriment'of Yir•&ries fll o BOARD OF FIRE PREVENTION REGULATIONS [Rcv.07]y�( Fb�k3 . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK • Al work to be perfomred is accordance with the Massachusetts Electrical Code(MEC)527 CMR 12.00 (PLEASEPRINT ININKOR 1IRE ALL INFORMATION) Date: 10(19/ 751 . City or Town of: 5ftsid04),) To the Inspector of Wires: By this application the tmdersigaed giy notice of his or her/Mention to peyform the lectical work described below. Location(Street&Number) 9 Q 11 (of) `,cv c) ( Wits} Owner or Tenant ;bin() SP ; I1stie TelephoneNo. Sct( i 73".IR Jp\ Owner's Address ' Is this permit inconjunction with abmidingpermit? Yes ❑ No d (Check Appropriate Box) • Purpose of Building Nc. UttlityAuthorization No. Existing Service Amps I. Volts Overhead❑ Undgrd❑ No.of Meters • New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: --Cc.01; f3 .s 4rty‘ (3000\ e,e).,/, Si fkn " )(it c(9 CQ173vIrd, zL t1 Pukeg4<ct+l'y, 1Taxi, Psd, 1 /Adm.( Sin., SW/less mks I , JJ• Completion of thefollowing table may be waived by the Inspector ofWires. ' No.of Recessed Luminaires No.of CelL-Snsp.(Paddle)Fans �`lo.o Total Transformers KVA _ No.'of Luminaire Outlets No.of Hot Tubs Generators EVA • Pool Above In- N o.of Emergency lighting No.of Luminaires Swimmin . g gnid. ❑ grid. ❑ 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 — InitiatimgDevices J No.of Ranges No.of Air Cowl. T• ons No.of Alerting Devices • Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: ,. Detection/Alerting Devices ' No.of Dishwashers Space/Area Heating KW Local El Connecption 0 Other ` No.of Dryers .' Heating Appliances KW Security Systems:'' (] rY No.of Devices or Equivalent / No.of Water KW No.of No.of Data Wring: . e Heaters Signs Ballasts No.of Devices or Equivalent ecotions Wiring: • No.Hydromassage Bathtubs No.of Motors Total HP Tel No.ofD uniCees or Equivalent _ OTHER: ' B Is Attach additional detail Vdesirec4 or as required by the Inspector of Wires. Estimated Value o E1e cal Work: 33. d0 (When required by municipal policy.) • Work to Start I I i a.kj�J�i Inspections 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 ❑ 011iba ❑ (Specify) • I certify,underthe pain and penalties ofper'ury,that the information on this application is true and complete - FD2MNAME: I DI LLC •)&3 •s St.cu- �a . LIC-NO.: I�- Licensee:1+{pMy s- J 1.._ E5 : y'.: LIC.NO.: I 7a (Ifapplicable,eente�rG-"exempt"in the li ense number line.) Bus.TeL No.C2t1—tf 47-277 a • Address: „CY�C Wi ?.q(, 2/10, T-L. um-T{irf, tbf oat/ S I Alt TeL No.: *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"License: • Lie.No. n n 1'T1 Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally C C .R9s4 9ll required bylaw. By nay signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent. • C +Owne /Agent PERMIT FEE:$ L. 0 0 P Signatture Telephone No. • Res; .