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Home My WebLink AboutBLDE-18-002782 Commonwealth of Official Use Only 41 Massachusetts Permit No. BLDE-18-002782 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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 ALLINFORMATION) Date:11/8/2017 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) 63 ALDEN RD Owner or Tenant WALL MARY E Telephone No. Owner's Address CIO KEVIN J JUDGE, 13 PARK ST, HARWICH, MA 02645 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 Furnace 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- 0 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ton. No.of Waste Disposers Ilea[Pump Number Tons KW No.of Self-Contained Totals: Detection/Alanine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection Systems:*ty S No.of Dryers Heating Appliances KW Security Y No.of Devices iv s or Equalent 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 lIP Telecommunications Wiring: o,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: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (Ifapplicable,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) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 • ( 11( 71, 9 vc___ -1 v' //JJ /j/�// / Vcommonto of///a,...cL�.ti.1 . , se On �\ � apartment Th (� ,2 C2 lSJ �/ ' t'= apartment 1 tiro Serviced Permit No. ,1 Occupancy and Fee Checked rJ BOARD OF ARE PREVENTION REGULATIONS ev. l/07) (]cave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordance with the Massachusetts Electrical Code(MEC),0 7 Chia 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To t h e I .ecto of Wires: . By this application the pndersigied gives notice of his or her intention to perform the electrical work described below. • Location(Street&Number)6S �.cle_4 t. Ad- • Owner'or Tenant chis C4_aL k6, , Telephone No. a Owner's Address �� b Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check A ro - Purpose of BttiIding PP P �Boz) /�� Utility Authorization No. 01 - Existing Service Amps / Volts Overhead Q Undgrd ill s ❑ No.of Meters ; New Service en 1oAmps / Volts Overhead❑ Undgrd❑ No.of Meters cv +('' Number of Feeders and.4/opacity l 6". 1 Location and Nature of Proposed Electrical Work: Iwiirt✓ ntsu Eu4I.,44.e..G citi i W.,1I: Completion of the follawinz table may be waived by the Inspector of}l sirs. No.of Recessed Luminaires INo.of CeIL-Susp.(Paddle)Fans No,of Total f f Transformers KVA e No. of Luminaire Outlets INo.rof Hot Tabs Generators • KVA ' No.of Luminaires Swimmi¢gPool '6 bove 0In_ IN o.of emergency L ghnng — . end., ered.rBattervunits No. of Receptacle Outlets No.of Oil Burners IFIRE ALARMS 'No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges INo.of Air Cond. Total Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I TCW INDo, etof Self-Contajmea Totals: ection/AJerting Devices No. of Dishwashers Space/Area Heating KW' L, Municipal - ❑Connection 0 Other No. of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Egnfvalent Heaters KWNo. of No.of Ballasts Data Wiring: Signs No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications'Wiring, No.of Devices or Equivalent 0 t.ihR: - Attach additional detail if derired,or as required by the Inspector of Wires. 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 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 an penolrf s of per jury,that the information on this application is true and complete FIRM NAME: LIG NO.: Licensee:lb.ecm:,,, ( 1-. i ce. Signature t',2,(? MC.NO: a (If applicable,enter "apt"in the license number line.) �- Bus.TeL No.. Address: St'> A- 1/i y ) A ,,.. /. o24. ,J `Per M.O.L.c. 147, s.57-61,securitywork requiresAlt. No.:SU:r77�t 3 ,� Deparunrnt of Public Safety"S"License: Tel..No. tt OWNER'S q NE Ry INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normallyBy my signature below,I hereby waive this requirement I am the(check one)0 owner owner's agent , Owner/Agent Signature • Telephone No. I PERMIT FEE: $