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Home My WebLink AboutBLDE-19-3321 d Commonwealth of• OffcialUseOnly tE Massachusetts Permit No. BLDE-19-003321 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:11/30/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of ms or her intention to dorm the electrical scribed,below Location(Street&Number) 1 CAPT WRIGHT RD Q,2.(,E Owner or Tenant WHITNEY PEGGY N TR Telephone No. Owner's Address THE P N WHITNEY QUALIFIED PERSONAL TRUST, 1 CAPT WRIGHT RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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 HVAC. 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- ❑ No.of Emergency Lighting grnd. grad. Battery 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 Initiatine Devices No.of Ranges No.of Air Cond. 1 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 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 0 (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"exempt"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's agent. Owner/Agent Signature ! Telephone No. PERMIT FEE: $50.00 t( ) 198 �� Coruna. rsmeaki oil it/aesachatetfe ilsiOn_y3t i c•� c� n (lf 5 ts /�f .LJsParfinenE of,y;n J .r•Permit No. BOARD OF FIRE PREVENTION REGULATIONS OccupancyandFeeChecked 5-SV �(� xer. lro7) ' _ "J f (leave blank) y� APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Code C),527 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION Date: / / a Q /7— City or Town of: YARMOUTH To the I ector of Wires: . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • . Location(Street&Number) / core,„, taty.utitS _�� Owner'orTenant ( r wt.o t n / Telephone No. __ Owner's Address —� mi rip.---.1z Is 's permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) > io :.Pu se of Building Utility Authorization No. cri g I I11 i 'ng Service_ Amps / Volts Overhead ❑ Uadgrd❑ No.of Meters _ L \sta) fri Service Amps. / Volts Overhead❑ Und d gr ❑ No.oCMeters Iglu/abar of Feeders and Ampacity %.:-Lo tion and Nature of Proposed Electrical Work: AA Im v'I W t A. /Ls? [.�c.ewa,. i T[9rin4G.c ->'- ` Completion of the followinztable may be waived by the Inspector of Woes No.of Recessed Luminaires Na of Cert-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Pool Above In- No.OeTkry mergency Lighting - g grid. grid ❑ 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 J • InitiathtgDevices No.of Ranges No.of Air Cord. Total No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW No.ofSelf-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑Municipal Connection 0 Other iNo.of Dryers Heating Appliances Kr Security Systems:* y No.of Water No.of Na of Deices or Equivalent KW Heaters No.of Data Wiring: S Signs Ballasts No.of Devices or Equivalent I No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirin : - Na of Devices or Equivalent OTHER: _ Attach additional detail V desired,or as required by the Inspector of{Firer. b 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: INSURANCE'S BOND 0 OTHER ❑ (Specify:) I certify, under the pains and pen ofperjury,that the information on this application is true and complete. FIRM NAME: / 0 � LIC NO.: Licensee: l6 - O ')/"r.t I., 1 7 • ✓, 4.lta..� Signature y „.,._., , LIC.NO.•2 (If applicable,enter"eze�/n'pt"in the license number line) Address: $7 R t, Jl��yr s L n. A 47 t, o y,`,`Lj Bus.Tel.No:_ j Per M.G.L.c. 147,s.57-6(,securitywork requiresAlt TeL No.: ______ 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 nrm required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. r Owner/Agent 01 Signature Telephone No. I PERMIT FEE: $