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Home My WebLink AboutE-19-1997 N. et \\ Commonwealth of Official Use Only 1e a Massachusetts Permit No. BLDE-19-001997 ttwil BOARD OF FIRE PREVENTION REGULATIONS . Occupancy and Fee Checked fRev.l/071 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:10/3/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the electrical work described below. �"„ —340* �� Location(Street&Number) 79 HOMESTEAD LN l� Owner or Tenant WEEKS NATHAN C Telephone No. Owner's Address WEEKS MARION 5,79 HOMESTEAD LN,YARMOUTH PORT, MA 02675-1223 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) .i 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: Install generator 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 1 . KVA 9 No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd, grad. Battery Units No.of Receptacle Outlets • No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Cas 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 ❑ Municipal ❑ 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 Siena 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 perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$50.00 re trommonertallh 0f,./addaCfldJ Official Use Only y,._ f� c7 �s • as Theioc rbntnt I Thee....Cervices No. !I- BOARD OF FIRE PREVENTION REGULATIONS ROccu/07cy and Fee Checked ev. lpant Ca iAPPLICATION 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: I icy, II City or Town of: YARMOUTH To the Inspector of Wires: iliaL $}f this application the undersigned give,s nog e of his or h. intention to perform the electrical work described below. • t4 ation (Street&Numb r) J ,intent �� I n�1 vle : " a er'orTenant ��U / o .. L � i .. Telephone No. ZI. _1J G 0 er's Address1.4 _ca,) ¢, i-C � /Iv _is is permit in conjunction with a bnBding permit? Yes ❑ No [ (Check AppropriateSox) f ` o ose of Building r Qs'el$ I.D �! Utility Authorization No. �`/�— L el n.3 sting Service Amps / Li Volts Overhead0 ..__ _ Undgrd No.of Meters Number of Feeders and Ampacity • Lo tion and Nature of Proposed Electrical Work: 0 l .. :/ . CCp�/, i .I 14�J1atI � CnWar �� t- ' '• • t IMI.jfignml iyl r • .lesion a the ollawin_ table • b waived, the Ins.- for a Wires. No.of Recessed Luminaires Na of C Snap.(Paddle)Fans 'o.of To.'' Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool 'ove 0 n- `o.o mergency n g• .ng d. trod. 0 Butte • Units No.of Receptacle Outlets No.of Orn Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o i etechon an. Inittatin_ Devices o No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers 'eat •ump ` ons '" o.0 el ontam-. Totals: Deteetion/Alertin_ Devices No.of Dishwashers Space/Area Heating KW L iP 0 Connection 0 Other No.of Dryers Heating Appliances KR, ecurity Systems:" `o.o "ater .o No.of Devices or E.trivalent Heaters KW o '0.° Data Wiring: Si•ns Ballasts _ No.of Devices or E.uivalent No.Hydromassage Bathtubs No.of Motors Total HP ecommuaicauons ' tying: No.of Devices or .uivalent OTHER: /`�� Attach additional detail if desire4 or as required by the Inspector of Wires. Estimated Value of Ejecttical Work / I(! (When required by municipal policy.) Work to Start: (�t ( 2df�Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA(E: 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 OND 0 OTHER 0 (Specify:) I certify, under the pains and pe al s pert, that a information .n this application is true and complete. A FIRM NAME: a t(�, � /V LIC.NO.: m Licensee: Signature j ,, 4 LIC.NO.: // (If applicable,enter"exempt"in the license number line.) B s.Tel.No.: Address: Alt.Tel.No.: J `Per M.G.L.c. 147,s.57.61,security work requires Department of Public Safety"S"License: Lic.No. — OWNER'S INSU CE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally •C requiredAbylat, y y si ature below,I ereb waive this requirement. I am the(check one)0 owner 0 owner's agent el Signature 1Q�r c e Telephone No..,ZE-L-,/fisfit PERMIT FEE: 5 5D j