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Home My WebLink AboutBLDE-19-002869 Commonwealth of Official Use Only V AS Massachusetts Permit No. BLDE-19-002869 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:11/9/2018 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) 71 DRIFTWOOD LN Owner or Tenant SYLVIA TERRY N Telephone No. Owner's Address SYLVIA MARSHA S, 71 DRIFTWOOD LN,SOUTH YARMOUTH,MA 02664-1011 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&receptacle for water heater. 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 Abe ov ❑ ln- a No,of Emergency Lighting god! grnd. Battery Units No.of Receptacle Outlets 1 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Imtiahne Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat PumpI Number Tons KW No.of Self-Contained Totals: Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: DANIEL 0 WILKEY Licensee: Daniel 0 Wilkey Signature LIC.NO.: 32288 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 CENTER ST, SOUTH DENNIS MA 026603744 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 V/ • an r� // mmo. rune of mmsachuaaffs • Official Use Only 4% . ! c''r, c7 rs4-V�7 'ri JJsParfinenf o/,ytire�'e,r ices •Permit No. _' - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 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 ORTYPE ALL INFORMATI01V) Date: NOV 9 J City or Town of: YARMOUTH To the Inspector of Wires: • By this application the{mdersigned gives notice of ' or her intend.. to perform the electrical work described below. . Location (Street&Number) Vt:3 Owher�orYenaat SCC` • ,� w id et I Y (� ) �} Owner's Address Telephone No.3/2/-�"'11. -' u- ' Js this permit in conjunction with a building t? Yes ❑ No ❑ (Check Appropriate Box) i..%.---I z + urpose of Building nnF FA M t by E)11Authorization LI • no- ' Utility No. y. i Acting Service ZOO Amps loo/agolts Overhead ❑ UndgVd❑ No.of Meters > rain,w_ r I gr _ et- I ew Service Amps / Volts Overhead 0 Undgrd"W ❑ Na.of Meters .. l i o i Vnmber of Feeders and Ampacity () 1D I soca ' and Nature Proposed Electrical W k: W zU ° [ )op 6T loA451- ('Ilio z Ce es m Completion of thefollowingmble may be waived by the Inspector of Wirer. o.of Recessed Luminaires No.of Cal Sasp.(Paddle)Fans No.of Total Id Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- No.of t•mergency Lighting crud. 0 gruel. D Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones - No.of Switches No.of Gas Burners No.of Detection and • Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Hest Pump I Number ITons IKW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal Low 0 Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:' No.of Water No.ofNo.of Devices or Equivalent Heaters No.°I Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications firing: Na Equivalent of Devices or OTHER _ �'+ ._ Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical World ! (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 ON BOND ❑ OTHER 0 (Specify.) I terrify, under the pains and penalties o FIRM NAM • jPul nrY.that the injormati•. ,n this applic••':nit true and complete. � A' .// LIC.NO.: Licensee: ite `A`y Signature 474 7 LIC.NO.:- E (If applicable,enter"exempt"In the license .er line) Address: Bus.Alt Tel.No: j `Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety TeL No:� eP "S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally i required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent t Owner/Agent Signature Telephone No. I PERMIT FEE: $ ��