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Home My WebLink AboutBLDE-19-003276 • Commonwealth of Official Use Only / PermilNo. BLDE-19-003276 E Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.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:11/29/2018 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) 158 THACHER SHORE RD Owner or Tenant AYLMER DAVID H Telephone No. Owner's Address HUCKINS JOAN E, PO BOX 54,YARMOUTH PORT, MA 02675-0054 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 ❑ 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: Ground service&bond water. 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. grnd. ,Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches I 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* iNo.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters ,Signs Ballasts IND.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: Charles K Swanson Licensee: Charles K Swanson Signature LIC.NO.: 12895 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:718 CEDAR ST,W BARNSTABLE MA 026681300 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 gpitcl CO vi ammo' ravaalth of Massaach umat • Official Use Only Permit No. e - J 2-7‘ . st jjn 1sparlmenlo`virJrvicat TIE- Occupancy BOAand Fee Checked RD OF FIRE PREVENTION REGULATIONS . Iro71 (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be pa{mmed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: IVIS= i? City or Town of: YARMOUTH To the Inspector of Wires: By this application the Imdersigned gives notice of his or her intention to perform .e electrical work described below. . Location (Street&Number) /p pgi ,'p L., 0 LAc... Pc9. i lM6J iL Owner'or Tenant /AV Q 4'0' 4 MAC Telephone No. Owner's Address -- ' Is this permit in conjunction with a building permit? Yes 0 NoCheck Purpose of Badding ( Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead Q Undgrd 0 No.of Meters _ New Service _ Amps / Volts Overhead 0 Undgrd 0 Na.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wort C1 crurrj. 5?to ec e_ C.,4_ Q b () Completion of the followinvable may be waived by the Inspector of Wires. No.of Recessed Luminaires Na.of Cetl-Susp.(Paddle)Fans • No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmia Pool Above ln_ No.ol`F.mergency Lighting - g ern!. ❑ grod. 0 Battery Units No.of Receptacle Outlets No.of Oil Ruiners FIRE ALARMS (No.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 (Tons I KW No.of Self-Contained - Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection ❑ other No.of Dryers Heating Appliances ICW Security Systems:" - No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data�l�g Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications Wiring: - • No.of Devices or Equivalent _ Estimated Value Of Electrical Wolk: 2-423 - Attach additional detail if desire or as required by the Inspector of Wirer. Workm t Start e"-��- (When required by municipal policy.) 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 W.ND 0 OTHER 0 (Specify.) I terrify, under the aims and p of perjury,that the information on this application is true and complet .- FIRM NAME: ClAce" cS ScO eawiN_ LIC.NaI S Licensee: Stgnatn� IC.NO.: gir.3(O 3 af Adds applicable.enter"exempt"in the license number tine.) Bus.Tel.No. Address. cy6 j `Per M.G.L.e. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not ave the liabilityLin.No. < required bylaw. Bymysignaturee insurancewcoverage normally q� below,I hereby waive this requirement. I am the(check one)0owner 0 owner's a eat. t Owner/Agentg Signature. Telephone No. I PERMIT FEE:$ I