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Home My WebLink AboutBLDE-19-002390 .a . Commonwealth of Official Use Only vrttyi Massachusetts Permit No. BLDE-19-002390 L BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:10/22/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to per ii .ti- -lea wor crib d Blow. � Location(Street&Number) 29 SILVER LEAF LN l bl r Owner or Tenant SANCHEZ PRISCILLA A Telephone No. • Owner's Address 303 BROOKSBY VILLAGE DR#721, PEABODY,MA 01960 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 ❑ 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: Wiring for shed. 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- o No.of Emergency Lighting grnd. id. Battery Units No.of Receptacle Outlets 20 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 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 ❑ 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 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 perjury,that the information on this application is true and complete. FIRM NAME: ROBERT J CARLSON Licensee: Robert J Carlson Signature LIC.NO.: 16945 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:39 NAUSET RD,W YARMOUTH MA 026733752 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:$75.00 l' r]h ile re- om 4(7oIiere_ ..‘,0 ,• • Commonwra&o/rr/amachade s 91.Titlegic Only Permit No. cy c� I39c it ii -, JJepapt rent o1.tin.....cervica^ti's Cdr Occupancy and Fee Checked T.':*I 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 IN INK OR TYPE ALL INPORTION) Date: /O — .2 2 -/r City or Town of:/✓ )/6t'�`cci' /ATo 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) /q .S'//k9t A/Pyr° Owner or Tenant c2.irr ,N9/o;rp//JL' Telephone No. KY4 C - .ib I ;C38� Owner's Address • Is this permit in conjunction with a building permit? Yes IDNog (Check Appropriate Box) , Purpose of Building u'/CR Y49/./ e ngdxwftt Utility Authorization No. Existing Service/) Amps /VI j%' 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: $r.I,k Y,t14 IMcnp,r /00 nil ,)TAL'L'Y TutGns, / fe ,, Completion oft the following table may be waived by the Inspector of fires. No.of Recessed Luminaires No.of Ceil:Snsp.(Paddle)Fans Transformers - KVA l ' No.of Luminaire Outlets No.of Hot Tubs Generators KVA -t; No.of Luminaires a Swimming Poo1 Above In- o No.of Emergency lighting grnd. grnd. Battery Units t No.of Receptacle Outlets .20 No.of Oil Burners FIRE ALARMS No.of Zones ' No.of SwitchesNo.of Gas Burners No.of Detection and s_ 9Initiating Devices III No.of Ranges No.of Mr Cond. Torsi No.of Alerting Devices %.‘k No.of Waste Disposers Heat Pump Number.Tons _ KW No.of Self-Contained a p Totals: "� Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munnectionicipaln ❑ Other C No.of Dryers Heating Appliances KW Sec No ouriyof Detems:* vices or Equivalent No.of Water No.of No.of Data Wiring: Haters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications oof Devices Equivalent NT OTHER: Attach additional detail if desired,or as required by the Inspector of Aires. Estimated Value of Electrical Work: 600, oo (When required by municipal policy.) Work to Start:-,/,-.5.1-/r 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 ® BOND 0 OTHER ❑ (Specify:) I certify,under thefains and penalties!itilerjutthat the information on this application is true and complete. FIRM NAME: CSW /fan/ /re/A !' LIC.NO.: /6 9 9 �v Licensee:rneccrr al,//49,04../ Signature .6404—,LIC.NO.:E 3,rel-6 / (fapplicable,enter'exe_mt"in the license number lel cBus.Tel.No. Address: ` .p /I// / i T /I L.)7'l74/ I�7 AIL TeL No.:l 9 Y 2 Ce/,b *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)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$