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Home My WebLink AboutBLDE-19-002846 ICommonwealth of Official Use Only " Massachusetts Permit No. BLDE-19-002846 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked rRev.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 ALL INFORMATION) Date:11/8/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomr the c cl cfncal work described below. Location(Street&Number) 126 CAPT NICKERSON RD Owner or Tenant VALERIO RONALD R Telephone No. Owner's Address VALERIO LUANN E, 13 OLD CART RD,AUBURN, MA 01501 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement furnace. Completion of the following table maybe 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- 1:1No.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 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 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 petjury,that the information on this application is true and complete. FIRM NAME: Joseph W Silva Licensee: Joseph W Sitva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 9&co III It le M-01 Alt-L tint_ �(zc5,°t...cc &ma mea&4maataclaeetfe Official Use Only - _ r __ T�ar6„ent o{ e.warless r MEW*: P No. • pie -, _. Occupancy and Fee Checked 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),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: /D— / Z 7/ F - City or Town of: ,//I/t-i''1 vu7/le To the Inspector of Wires: By this application the undersigned�gi/ves notice of his or her intention to perform the electrical work described below. Location(Street&Number) /24 a4I'7 N/C.JCE2So 4 R-0 Owner or Tenant ona-i.(J /A-L£/c-1 O Telephone No. Owner's Address Sri-nf., Is this permit in conjunction with a building permit? Yes ❑ No IEV (Check Appropriate Box) Purpose of Building 5'/n/5 GL /4/I17t Utility Authorisation Na Existing Service Amps / Volts Overhead❑ 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 tt1//tC (C�,4.LErlt4/ Sic cj ,..... .,ce Completion of the foil. table may be waived by the/erector of Wires. Tr KVA Total Na of Recessed Luminaires Na of Cell.-Susp.(Paddle)Fans Tof Transformers KVA No.of Luminaire Outlets Na of Hot Tubs Generators KVA Na of Luminaires Swimmia Pool Above ❑ In- ❑ Na of Emergency Lighting g grad grad Battery Units No.ofReceptacle Outlets No.of Oil Burners FIRE ALARMS Na of Zones Na of Switches Na of Gas Burners Na of Detection and Initiating Devices Na of Ranges Na of Air Cond. Total No.of Alerting Devices Na of Waste Disposers Hat Pump Number Tons KW Na of Self-Contained Totals: Detection/Alerting Devices Na of Dishwashers Space/Area Heating KW Load❑ Municipalection ❑ Otho - Coun Na of Dryers Hating Appliances KW Security Systems:* Na of Devices or Equivalent Na of Water , Na of No.of Data Wiring: Haters Signs Ballasts Na of Devices or Equivalent No.Hydromassage Bathtubs Na of Motors Total HP TelecommunicationsNo.ofDeceor �rm� Na of Devices Equivalent OTHER Attach additional detail rfdesirer(or as regrmed by the Inspector of Wires. Estimated Value of Electrical W(odc: (When required by municipal policy.) Work to Start:JD'1Z- —/a 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 coversejs in force,and has exhibited proof of same to the permit issuing ofii CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) �n�L s se 9 I crib,under the pains and penaltks of perjury,that the information on thb application is true and complete. FIRM NAME: Sit-VA- 'C.«7,c4 C_ LIC.NO.:/d 9 i il 7 Licensee:Co S e.4:41 IA StLita•St- Signature LIC.NO.: (If applicable,senter"exempt"in the license number line.) , Bus.TeL Na• _ 8- L. -` 08Z Address: :50 3rw(c,.i i- /PA.7 I2 A.apu>q a.0, con ban s a C Alt.TeL Na:Th B t(J-9 21( *Per M.G.L.C. 147,a 57-61,security work requires Department of Public Safety"S"License: Lie.No. OWNER'S INSURANCE WAIVER I ani 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/Agent Signature Telephone Na I PERMITTEE:S