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Home My WebLink AboutE-19-1757 Commonwealth of '--Official Use Only ` p`a Massachusetts Permit No. BLDE-19-001757 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.l/07j 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 PR/NTININK OR TYPE ALLINFORMATION) Date:9/24/2018 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) 111 STARBUCK LN Owner or Tenant GARNHUM DANIEL P Telephone No. Owner's Address LEGER LINDA J, 111 STARBUCK LN,YARMOUTH PORT,MA 02675 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 ❑ 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: Wiring for second floor addition. 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 1 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 16 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 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 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 Slens 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: William H Nelson Licensee: William H Nelson Signature LIC.NO.: 26513 (Ifapplicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:871 BUMPS RIVER RD,CENTERVILLE MA 026323321 Mt.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:$75.00 SZv c.j'f 9/2 8 - frif & iq aF(l8 et" v �_ esmmonw tr/aesachivaetti Official Use `' CY � � ccyy Permit No. `.75 z.ei_ 1Japartment o er'rcte • - - BOARD OF FIRE PREVENTION REGULATIONS ev Occupancy07Jand Fee Cnkked (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: gq /g City or Town of: YARMOUTH To the Insp ctor of Wires: I . By this application the undersigned gives nod 9f his her i tendon Io perform the electrical work described below. • Location (Street&Number) /J SteRV) Lj AA /�g_474 Owner or Tenant ��h en i �jgrh4d i Telephone No..___-_____ N. Owner's Address SGveytL Is this permit in conjunction wit a b in Purpose of Buildingg pt/.� 'Yes � No 0 (Check Appropriate Box) ...chlit... feyran)//1 earletit Yw J! Utility Authorization No. ti - Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters (yd Ne; S ee Amps / Volts Overhead ID Undgrd❑ No.of Meters > o Na`,�. . of Feeders and Ampacity b Ld�ora. .n and Nature of Proposed Electrical Work LU�� ILLI L� 172d/t GJYd T» Ayv ✓� t+[ t?D7 C) NL co) ; i Do rm-or' /r�ti7��r� Cle Completion of the following table may be waived by the Inspector ofWires. W $ii. Recessed Luminaires Na.of Cer7.-Susp.(Paddle)Fans No.of Total Transformers EVA f Luminaire Outlets No.of Hot Tubs Generators KVA . •f Luminaires Swimming Pool Above 0 ln-d. ❑ BanNo,or eryEUnitsmergency Lighting grnd. No.of Receptacle Outlets /, No.of OE Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Too No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number 'Tons KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Manlcrpal Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water Na.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: Attach additional detail ydesired 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 coovv rage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cent)", under the pains an penalties ofperjury,that the information on this application is true and complete. FIRM NAME: �/ LIC.NO.: Licensee: 7G?n , L�i,sOh SI arum bass/j�/ LIC.NO.:.(Sf.3" (Ifapplicab e.enter 4"in the license m�y�gr/inn) ,/ ,r ter— Bus.Tel.No.• ,� Address. 42? ,4e2YT /Cpl Of YtpJ/�Z f7fi Ls�w.� Alt.Tei.No.;sllg %IL�T r�7y J Per M.G.L.c. 147,s.57-61,security work requires 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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's a ent. r Owner/Agenta al Signature Telephone No. I PERMIT FEE: $ {C> I