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Home My WebLink AboutBLDE-19-000925 ` Commonwealth of Official Use Only tt E Massachusetts Permit No. BLDE-19-000925 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.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:8/16/2018 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) 48 LEWIS RD Owner or Tenant HOUGHTON RONALD F Telephone No. Owner's Address HOUGHTON WENDY C,48 LEWIS RD,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (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: Relocate receptacles. 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 PoolAbove ❑ In- ❑ No.of Emergency Lighting rnd. grn . Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches 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 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 BathtubsNo.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 ❑ BOND 0 OTHER Cl (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 Signatures Telephone No. PERMIT FEE:$50.00 11/ d([w/i5 A. l.ammosung&of rr/attac its Offs 'al Use Onl lJrParGnanE DI Thee ServicedPermit No. ( `-'L / T Z' ' BOARD OF FIRE PREVENTION REGULATIONS Occup evv ancY and Fee Checked 7J (leave blank) • APPLICATION FOR.PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA770N) Date: /4" — /r City or Town of: YARMOUTH To the Inspector of Wires: • . By this application the Imdeisigned gives notice of his or her intention to perform the electrical work described below. Location(Street&NNuumber) 167 ./� Q� — Owner'orTenant I,ealit/,c,f' / rn / Ian/ TelephoneNo.. 7221 C7y&" Owner's Address 97 z el-,..v? aid i Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 14D Amps ga/SP()Volts Overhead 3 Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity rif�47,A) CeMaznf 7frrol4 .1 /0760//e • Location and Nature of Proposed Electrical Work: ,9vyj,41>` ,2 CJaye/` 4/ M yC! /,0j0 ve ole/v / Movt M/C/lo G✓if t4- / &Wet Completion of thefoflowin&table may be waived try the Inspector of Wires. No.of Recessed LuminairesNo of Cel.Snap.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.ottteryEUnitsmergency Lighting . Eruct. rind. 0 Ba 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 No.of Ranges No.of Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Connection ❑ °th? No.of Dryers Heating Appliances Kr Security Systems:' - No.of Water No.of No.of Devices or Equivalent Heaters KW 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 ifdesired or as required try the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start F-1/4 ^/7-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 0 BOND 0 OTHER 0 (Specify:) I cerafy, under the pains and penalties ofpe 'ury,that the information on this application is true and complete. FIRM NAM$, ej��`(O� cc£G/ll.a,' LIC.NO.: P Licensee ..1.7 Signator jee# Vale ,..,_ LIC.NO.:1-,..7 2-27---.45 Addreas(If ble,enter"ex t"in the lipetnr�nu ber line) ` `Bus.Tel.No: ?Q #e4 /4! 4 W 9n,19 ," Alt.Tel.No.'SuQ:S� 9 4'4 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)0 owner ❑owner's agent t Owner/Agent al Signature Telephone No. . I PERMIT FEE: $