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Home My WebLink AboutBLDE-9-003136 • Commonwealth of Official Use Only t E Massachusetts Permit No. BLDE-19-003136 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:11/20/2018 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) 121 NORTH MAIN ST Owner or Tenant SEARS STEPHEN K Telephone No. Owner's Address SEARS PAULA J, 121 NORTH MAIN ST,SOUTH YARMOUTH,MA 02664-3119 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 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: Service upgrade.(Panel replacement) 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 Rind, grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners 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. 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 0 Municipal ❑ 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 0 BOND ❑ OTHER 0 (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 Signature Telephone No. PERMIT FEE:$50.00 hl ennertonmealg of trlaisac its Official Use Onty trcyyServices 7 —� -711-,;„ 3sparimenf of Tire J Permit No. l �l Q arvia! . ro • -sc 7) (leave BOARD OF FIRE PREVENTION REGULATIONS CTI/0and Fee lank ___5 ry I 7] blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: //— ZO — /or City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. • . Location (Street&Number) /2 / tt10//5' /146JA.:‘,/ v0/ Owner•orTenant SIM yr. S2*'A's Telephone No. • • .er's Address S/rt/e 1- P/9Ohtt SC/9 e . 2 G/ 0 Ab• •,' permit in eonjnnctionTti abuilding permit? Yes ❑ N � o ., 0 (Check Appropriate Box) Ll1 CO Pu ose of Buiiding,sin/ /t N /` �.Ais,�rY (//.�J7/�i�t.e7t11ity Authorization No. Exii•ng Service //fin Amps //d/$'1OVolts OverhCdd Und O w �t� grd❑ No.of Meters W '� C: Roe i Service Ams D tr Undgrd 0 No.of Meters / /!JQ_ P //lJ, Volts Overhead V rib. C 11,1 ber of Feeders and Ampacity 77,✓9 4Q0 ,,.__ .er w Z and Nature of Proposed Electrical Work: �4tce .ry / rY (//'re/ c"`j/},r/� r(/r. r, i✓ Completion of the followingeable may be waived by the Impactor of Wires. No.of Recessed Luminaires No.of Ceti-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimmla Pool Above In- No.of N.mergency Lighting - g Ahe D In-d. 0 Battery Units No.of Receptacle Outlets . No.of OR 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. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number ITons IKW No.of Self-contained - Totals:1 Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Mani ' al Local 0 Connection 0 other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent ' No.of Water No.of Heaters KV No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: Na of Devices or Equivalent OTHER: Attach additional detail f desired or as required by the Inspector of Wires. Estimated Value of Electrical World $(2j, p/ (When required by municipal policy.) Work to Start //- to "FIaspections 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 certfy, under the pains and penalties ofperfury,that the information on this application is true and complete. FIRM NAME: - _ / LIC NO.:/511‘ 9 5.15-- Licensee:9rq/ r77 /fes✓ Signatur ,�.„firosera:, IC NO.:L 3?r€ 9 (If applicabl5,,enter"exempt"in .4e_licesse,tinber line. --� Address S 9 /t/,grrrl7/ /7 w �? a f� Bus.Tel.No.:J...ES2y y/� 'Per M.G.L. c. 147,s.57-61,security work requiresAlt.Tel.No.:________ry Department of Public Sa cry"S"License: Lie.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)❑owner ❑owner's agent i Owner/Agent 01 Signature Telephone No. I PERMIT FEE: $