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HomeMy WebLinkAboutBLDE-19-002478 .• c� 1e Commonwealth of offieialUse Only ft* Massachusetts Permit No. BLDE-19-002478 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:10/25/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of has or her intention to pertothe electrical work dg. below. Location(Street&Number) 39 HARBOR RD t,�/]�I(ri1/43 1 (i/ Owner or Tenant DUBE ELEANOR R Telephone No. Owner's Address 39 HARBOR ROAD,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: Replacement HVAC&water heater. 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 Ab ❑ In- CINo.of Emergency Lighting grnove d. grnd. Battery Units _ No,of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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 1 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete FIRM NAME: Charles K Swanson Licensee: Charles K Swanson Signature LIC.NO.: 12895 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:718 CEDAR ST,W BARNSTABLE MA 026681300 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 tyo(fe li . l..ommonmea o`//laeaac ff! cull Use On =:ill panne, E ol. S Stridees Permit No. L ' T /Cl \ _ss( • ' Occupancy and Fee Checked 3 BOARD OF FIRE PREVENTION REGULATIONS Itev, 1/07) ' (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEL),527 C 2.o0 (PLEASE PRINT IN MK OR TYPE ALL INFORMATION) Date: /0 a 2 f I a' City or Town of: YARMOUTH 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) 2S K r:a-loos• IRI Gi • Yarm....n iQ OwnerorTenant b1`tth I%IL/ Telephone No. Owner's Address —� Is this permit in conjunction with a building permit? Yes 0 No Purpose of Building AuthorizationyCheck Appropriate Box) Q Utility No. Sit ng Service Amps / Volts Overhead❑ Undgrd Ltd❑ No.of Meters �o :Li -1 entice Amps / Volts Overhead (, ❑ Undgrd 0 No.of Meters ... J` a /flu Ji,er of Feeders and Ampadty • /W. N . .-dontand Nature of Proposed Electrical Work: I) ,,,,��,�tt(tt� �r- / '�(/� � V s_ O i u i k _ A a Ce.. i t 8 f`e., l�-NGCYJ16Vl! (secs hN'NG G 't, \ i J CON V1 1 -}GIS W U 1CD I Co .letion o the ollowin: table m• be waived• the I .- for o Wirer. cr j of Recessed Luminaires No.of Cell.-Strsp.(Paddle)Fans `o•°f Total Transformers KVA m -o.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swpool g immin Above In- Nott,ofery Uergency lighting - gruel.. 0 gruel. ❑ Riflery No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners I No.of Detection and Initiating Devices No.of Ranges No.of Mr Cond. Total - I Tons 3 No.of Alerting Devices • No.of Waste Disposers Heat Pumpl Number ITons IK No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers Space/Area Heating lcW' Local 0 Municipal Connection ❑ °t'? No.of Dryers Heating Appliances KW Security Systems:* No.of WaterNo.of Devices or Equivalent Heaters / KW No.of No.of Data Wiring: - Signs Ballasts No.of Devices or Equivalent No,Hydromassage Bathtubs No.of Motors Total HP telecommunications Wiring: No.of Devices or Equivalent OTHER: _ 0Attach additional detail if derired or as required by the Inspector of Wires. Estimated Value of Electrical Work - 0 (When required by municipal policy.) Work to Start /O-2c(-(' 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 tg' BOND 0 OTHER 0 (Specify:) I cent", under the pains and penalties of perjary,that the information on this application is true and complet FIRM NAME: Cl,t t,..( .5©vk LIC.NO.: (`a. Licensee: SignatureAZZ '---...„ LIC.NO.: , 3 c o i (If applicable.ant "exem�ptn"in the license number line.) ,^^ Bus.Tel.No:�/ / Address: DC6- <7'tXot T' t- . r i`tnS ✓4l.r • �l J Per M.G.L.c. 147,s.57-61,securitywork requiresAlt TeL No.: Department of Public Safety"S"License: Lic.No. —�� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally irequired by law. By my signature below,I hereby waive this requirement Ithe one)0 owner ❑owner's a t. t Owner/Agent am (check / 1 SignatureTelephone No. ( PERMIT FEE: $ b 0