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Home My WebLink AboutBLDE-19-001308 `��` � Commonwealth of OfficialUseOnly t Massachusetts Permit No. BLDE-19-001308 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:8/31/2018 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. Location(Street&Number) 108 CRANBERRY LN Owner or Tenant CARROLL MARY THERESA Telephone No. Owner's Address 108 CRANBERRY LN,SOUTH YARMOUTH,MA 02664 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 ❑ 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 boiler. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeB:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets . No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above CIla- ❑ No.of Emergency Lighting grnd. grnd. Batters,Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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/Alertlne Devices No.of Dishwashers Space/Area Heating KW Local 0 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 ❑ BOND 0 OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application Is true and complete. FIRM NAME: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"crempt"in the license number line.) Bus.Tel.No.: • Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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'sagent. Owner/Agent Signature Telephone No. PERMIT[ FEE:$50.00 I L ( &f Ie Vela 11 (2.3 Q �}- u((9115kg--- _ l.o'nunoruora of tr/amachrasrtts e __ tar apartment of„yin J Permit No Ot5ci Us ervicd )kOccupancy and Fee Checked (J» BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/0 (leave blank) —�O r APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (I 577 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: / /5— City 5— City or Town of: YARMOUTH To the I ector of Wires: §/ . By this application the Imdersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) i err CR&n.A..rtt�y L `y F Owner'or Tenant p eLvt.r Ca A24 L1 ? Telephone No. • •‘ w Owner's Address IN Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) a Purpose of Building Utility Authorisation No. .--1w ' ' W cc o Existing Service Amps / Volts Overhead 0 Undgrd gird❑ No.of Meters C) = ZNew Service0 unfits o IAmps / Volts Overheadgird 0 No.of Meters 11•4 Number of Feeders and Ampacity cc 5 m m Location and Nature of Proposed Electrical Work; t.lzt'JL.r R,P(4e.rlat...e,ai Aele/L • Completion of thejollowing;table may be waived by the Inspector of Wirer. No.of Recessed Luminaires Na,of Cei1 Fansusp.(Paddle)FaNo.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- No.of Emergency Lighting - grnd. crud. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas limners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals:I I I Detection/AlerttingDevlces No.of Dishwashers Space/Area Heating KW totalMpa ❑Connectiouniciln ❑ efrthr No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters KWData 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 ijderire4 or as required by the Inspector of Wirer. Estimated Value of Electrical Work: (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: INSURANCEBOND 0 OTHER 0 (Specify:) tify, I cer , under the pains and pent 'es of perjury,that the information on this application is true and complete. FIRM NAME: / Tar I LIC.NO.: Licensee: - y kit. Signature 1,,, p / �6 �er"tit cJ• T f� �+�,.� LIC.Na: pjapplicable,enter" t in the license member line) / Bus.Tel.No: Address. se 9,-s LA. 44440.-ST7 ams yr,.:,.Of ..926 SAF- Alt.Tel.No- .9- 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 icrequired by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's a ent t Owner/Agentg jSignature Telephone No. I PERMIT FEE: $