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Home My WebLink AboutBLDE-19-003342 Commonwealth of Official Use Only /LS Massachusetts Permit No. BLDE-19-003342 _ 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:12/3/2018 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) 147 BERRY AVE Owner or Tenant HOLMES BRETT E Telephone No. Owner's Address PO BOX 1202,PROVINCETOWN,MA 02657 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 0 Undgrd ❑ 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- 1:1No.of Emergency Lighting grnd. gird. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches INo.of Gas Burners 1 No.of Detection and initiating 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 fdesired,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: DANIEL 0 WILKEY Licensee: Daniel 0 Wilkey Signature LIC.NO.: 32288 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 CENTER ST,SOUTH DENNIS MA 026603744 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:$50.00 44 12/3b oftz1 127// S I yy /� _.-� l-ommorsmr II///ae5aefE1 Of5 Use Only_ _ - 33 4 Z . \tlk Q =Eh eparlmrnt� [ s •PermitNo.>� o rrviud ie Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . lro73 (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.00 (PLEASE PPJJV7'Hi INK OR 2E ALL INFORMATION) Date: NoV, 30, 1$ bCity or Town of: YARMOUTH To the Inspector of Wires: By this application the tmdersigned gives nobs of his or her intention to perform the electrical work described below. Location (Street&Number) / to T`% 1 V W T 1 Owner or Tenant 7)ct+ _ 11 O M E) Telephone No. Owner's Address Isthis permit in conjunction with a ba ding ermit? Yes No ❑ 0 (Check Appropriate Box) • 0 &u lose of Butldmg t TAMii yci cJt(11 U � m �'� � _-- dtityl:athotizationNo o igri ng Service lfl Amps A�"aro Volts Overhead ®, Undgrd❑ No.of Meters N i�te Service p 1- Amps / Volts Overhead 0 Undgrd 0 No.of Meters IL c J�a ber of Feeders and Ampacity 0 , tion and Nature of Pro sed Electrical Wo TACE M EAT l qc aj 1 1)ThAcrs. ÷ 44.at r,Orldrili Ct (5 Completion of thefollowin&table may be waived by the Inspector of Wirer. Riot'Recessed Luminaires No.of CerltSusp.(Paddle)Fans No.of Total Transformers ICVA No.of Luminaire Outlets No.of Hot Tubs Generators ICVA No.of Luminaires Swimming Pool Above ❑ In-d. 0 BaNo.ttery Units ofergency Lighting — erred. In- No.of Receptacle Outlets No.of Ort 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. Ton No.of Alerting Devices • No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained Totals:I I I Detection/Alertlng Devices No.of Dishwashers • Space/Area HeatingKW' Municipal Low❑ Connection ❑ HH No.of Dryers Heating Appliances KVV Security Systems;* — No.of Water No.of Devices or Equivalent No.of Heaters No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs Na,of Motors Total HP Telecommunications Wiring; No of Devices or Equivalent OTHER • C �- Attach additional detail if desired 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: INSURANCE g 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: If . / LIC.NO.: Licensee: ' t `SMtar Slgnatu drAyer� LIC.NOrN vlfJ (If applicable,enter"exempt"in the licence num Cr line) Bus.Tel.No: �/'I Address: M.G.L. Alt.TeL No j •Pet M. c. 147,s.57-61,security work requires Department of Public Safety"5"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ic required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's/sive t Owner/Agent ` d Signature• Telephone No. ( PERMIT FEE: $ tJV