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Home My WebLink AboutBLDE-19-003448 , ` Commonwealth of OfficialUse Only �E:��w Permit No. BLDE-19-003448 Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked VRev.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:12/6/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomi the electrical work described below. Location(Street&Number) 33 LAKE RD Owner or Tenant INKLEY BRADFORD Telephone No. Owner's Address 33 LAKE ROAD,WEST YARMOUTH, MA 02673 . 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: Septic pump&alarm. 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 0 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 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 1 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 K V No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 vernfy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Steven J Paine Licensee: Steven J Paine Signature LIC.NO.: 12743 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:108 CONSTANCE AVE,W YARMOUTH MA 026731509 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 u(G Co,uout r^5 ect 9 i iji/125 62 f 1, / Commonwealth oil Micmac/midi tit-incl,�1,JUse Only// . . ryry,, gc7 -C Pemtit No. �` l — '7`tr6 - 2)epartment o�.yir*Service! Occupancy and Fee Checked 571077 BOARD OF FIRE PREVENTION REGULATIONS (Rev- 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code NEC),527 CMR 12.00 ' (PLEASE PRINT IN INK OR TYPE ALLINFORr��TION) Date: /a,lo6lieT City or Town of: )atpNOLrt'I 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)pLake Re ld P* 33 ,p Owner or Tenant ZA/f{ky - Telephone No. SYlt` '74.5-.3:514? Owner's Address 37 lake. mad LAJear YaRrno 9141, y2QOjs Is this permit in conjunction with a building permit? . Yes p No El-- (Check Appropriate Box) —Purpose of Building Utility Authorization No. r o E:t inIt',Service p?IOC) Amps /' / Co Volts Overhead®' Undgrd 0 No.of Meters J tu Ieo Nerd SNrvice Amps / Volts Overhead 0 Undgrd 0 No.of Meters 0 N Numble�'�'r of Feeders and Ampacity w tic L Itltup ILL ien and Nature of Proposed Electrical Work: • &i I Se c n Vn p �4 f6Rm' IL IL t� In Completion of the following table may be waived by the Inspector of Wires. No„of ecessed Luminaires • No.of Ceil.•Sus O. of Total I >C p.(Paddle)Fans -� i Transformers .KVA Net-of Luminaire Outlets. No.of Hot Tubs . .. . . ..... . Generators - - .. .KVA . . . No.of LuminairesSwimming Pool Above In- No.of Emergency Ltghtmg �rnd. ❑ grnd. ❑ Battery Units . No.of Receptacle Outlets . 4 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 NorofWaste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin!Devices . No:of Dishwashers Space/Area Heating KW L ❑ Municipal ❑ Other , ocal Connection No.of Dryers - Heating Appliances KW Security Systems:* No.of Water No.of No.of Na of Devices or Equivalent Ballasts Data Wiring: Heaters KW 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 ifdesire4 or as required by the Inspector of Wires. Estimated Value of El ctric I Work: 62100 (When required by municipal policy.) Work to Start . /a/ 8 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURd.NCE 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 ff... BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties ofperjuty,that the information on this application is true and complete. - • FIRM NAME: '/-�� t/p�(II�aItie etre/nem,/ /1 LIC.NO.: Ja7YS8 • Licensee: S't`et/.p QIA/ Signature ___ LIC.NO.: /Q75138 (If applicable,enter"exempt"in the license number line) //// Bus.Tel.No.-774,99y aV// Address: MR Cr/itch-Anne flit., toecn,tRAitVYL1 MA-0,0673 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires 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 normally required by law. By my 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: $