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Home My WebLink AboutBLDE-19-000909 A ly/ • ( • Official Use Only Commonwealth of ./1E. ;+,� Massachusetts PernitNo. BLDE-19-000909 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07j 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:8/15/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her mlention to pertorm the electrical work described below. Location(Street&Number) 55 ANASTASIA RD Owner or Tenant SCHECK ANTHONY A Telephone No. Owner's Address SCHECK IRENE E,62 SHEEPHILL RD.RIVERSIDE,CT 06878-1418 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: In-law apartment. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 6 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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 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 Siens 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 ❑ OTHER ❑ (Specify:) • I certify,under the pains and penalties of perjury,that the Information on this application is true and complete. FIRM NAME: MICHAEL TOTTEN Licensee: MICHAEL TOTTEN Signature LIC.NO.: 22421 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:228 STONEY CLIFF RD,CENTERVILLE MA 02632 Mt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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 t,6 e((G(e& re--- , 101i8 - vie _ - emwri nmealg of rr/addac lti Official Use On -y— c� c7 n ;Permit No. OP — O'i09 - ni_ apartment of.Yin Serviced - I�� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 4. ^ I et 1/07] . (leave blank) I\J APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C (MEPC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: gf ic/ 2-O(g City or Town of: YARMOUTH To the Inspector of Wires: • . By this application the imdersigned gives notice of his or her intention to perform the electrical work described below. . Location(Street&Number) 5S fr. 4-11.,5 i 4 Owner or Tenant ( wrey .2;-4-r Telephone No. 8 5b -114_5 ,4 Owner's Address Is this permit in conjunction with a building permit? Yes Er No 0 (Check Appropriate Box) Purpose of Build ng: LnW qi-J-.. Utility Authorization No. Existing Service /c o Amps (ZO /-2..(Q Volts Overhead 1117— Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 Ni.of Meters Cl Nuaber of Feeders and Ampacity ^ 1,....._ I�oc�donand Nature ofProposed Electrical Work: D„, „ taiL"t1 -Om" Cy„J Lk (AO y}„ . I-• II t„,.....,•I,,, J >al I N ,Q II _14::[.., �rr� !" Completion of the followinntable may be waived by the Inspector of Wires. d_)f No4 of Recessed Luminaires No.of Ca-Sus?.(Paddle)Fans No.of Total Cr) Transformers KVA _ C.) -. ; Noi of Luminaire Outlets No.of Hot Tubs Generators KVA C. tlj No��ot Luminaires Swimming Pool Above ❑ In- No.of T-mergency Lighting 1 t1! — arra erttd ❑ Battery Units i ho of Receptacle Outlets I No.of Oil Bnrvers FIRE ALARMS !No.of Zones No.of Switches G No.of Gas Burners No.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Too No.of Alerting Devices V • No,of Waste Disposers Heat Pump Number No.of Self-Contained Totals:I I Tons I KW Detection/Alerting Devices No.of Dishwashers • Space/Area Heating KW' LoCalMunicipal ❑Connection ❑ Other No.of Dryers Heating Appliances K1V Security Systems:" No.of Water No,of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent U No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: `� No.of Devices or Equivalent V) `-- OTHER: dl Attach additional detail if derire4 or as required by the Inspector of Wirer. M Estimated Value o El trical Work: 3570 ' (When required by municipal policy.) 1 qv Work to Start I Mar Inspections to be requested accordance with MEC Rule 10,and upon completion. O •- INSURANCE RAGE: 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 cov a is in force,and has exhibited proof of same to the permit issuing office. O CHECK ONE: INSURANCE al BOND 0 OTHER 0 (Specify:) O I cargo',under the pains and p wallies o aty,that the information on this application is true and complete. FIRM NAME: PAidtxM ( � FrGC rC LIC.NO.: /410W-3 Licensee: i ' Signature LW.NO.:..... t} d J 1 applicable,euro"exempt"in t e licence number line.) Bus.Tel.No.. -` Address: J *Per M.G.L.c. 147,s.57-61,securitywork requiresyAlt.TeL No.:�c.No. _ Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee doeslnot have the liability insuracense: rnce coverage normally — re red law. By q� by my signature below,I hereby waive this requirement. Tam the(check one)❑owner ❑owner's agent Owner/AgentIoi „\ Signature Telephone No. 1 PERMIT FEE: $ 1v