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Home My WebLink AboutE-19-2497 ap Commonwealth of Official Use Only E. Massachusetts Permit No. BLDE-19-002497 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:10/29/2018 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) 37 HIDDEN ACRES AVE Owner or Tenant PETERS FREDERICK P JR TRS Telephone No. Owner's Address PETERS JEANNE M TRS, 37 HIDDEN ACRES AVE,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 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 ❑ In- ElNo,of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners 1 No.of Detection and Initlatine 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/Alertine 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 Siens Ballasts ,No,of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total TIP (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: Gary L Gordon Licensee: Gary L Gordon Signature LTC.NO.: 15290 Ufapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:37 BILLINGSGATE DR,DENNIS MA 026382234Alt.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 z Q Telephone No. PERMIT FEE:$50.00 i vii a ( . .. CamrnGnVICS of I'/asaacAiaxiti Official1u e onlyy,..T(�, pn7 k', x,71 • ccyA cc'/ ��iJ Permit No. (57__Y"- ` / r0'w �j 2ipartmat of.}ire Jerekee moi(r,dr Occupancy and Fee Checked t qy BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/417] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),$27 CMR 2.00 (PLEASE PRINT IN INK OR TYPE ALL INFORM ON) Date: /0 Ian /r City or Town of: a(�(e^0 To the inspectJr of Wiles: By this application the undersigned ' s notice of his or �e,r/�rrtendon to forst the electrical work described below. Location(Street&Number) 37 /"'r l4"14 ./ l ore 9 J Owner or Tenant `'"C.460 wp STelephone No. Owner's Address Is this permit in conjunctio with b Ilding permit? Yes 0 No (Check Appropriate Box) Purpose of Building Utill Authorization No. Existing Service/OO Amps/4O /,.,7 y0 Volts Overhead Undgrd❑ No.of Meters / New Service4 _ Amps / Volts Overhead Undgrd❑ Na,of Meters Number of Feeders and Ampacity (A-) � / a-- cy�� c-Cf t-- 'ITQ�� Location and Nature of Proposed Electrical Work: V) Completion of the followinglable may be waived by the Inspector of Wires, No.or Total U1 No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans0. Transformers KVA 1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA -'- No.of Luminaires SwimmingPool Above Q In- Q vo.at Emergency tagutmg Arad. grad. Battery Units j No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and c Initiating Devices l Total No.of Ranges No.of Mr Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number, Tons KW No.of Self-Contained P Totals: ` Detection/Alerting Devices _,�tNo.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection CI No.of D ers Heating Appliances Key SecurityS stems:* r5 No.of Devices or Equivalent j No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent • N ¢ Telecommunications Wiring: i co Is Noal I .Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent 1 OTHER: ( U Attach additional detail if desired,or as required by the Inspector of Wires. ( O I_j Estimated Value of Electrical Work: (-3_7(7-2 (When required by municipal policy.) 4..............."-,.. 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 1!' BOND 0 OTHER ❑. (Specify:) I certify,under the pains and it ahie`r`i-"��I�perjury,that the information on this application is true and complete.. q FIRM NAME:c------- �rIJ02-07 z,Fre_ LIC.NO.://$?. /Q Licensee: �R.A--I `jyh jinn Signature LIC.NO.: ��j7/ (If applicable,enter'etnnet"in a license miler lingo .. Bus.Tel.No: p Address: 37 [SS vvjj17-A--e-I, ` "� AltTeLNo.:4� ��/ *Per M.G.L.c. 147,s.57-61,se2Grity Work requires Department of Public Safety"S"License: Lie.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)0 owner 0 owner's agent Owner/AgentPERMIT FEE:$ SignatureturaTelephone No.