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Home My WebLink AboutE-19-430 • Commonwealth of Official Use Only ! y trLo Massachusetts Permit No. BLDE-19-000430 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:7/23/2018 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) 100 WHARF LN Owner or Tenant MARCHILDON JOHN L TRS Telephone No. Owner's Address MARCHILDON DOROTHY E, 100 WHARF LN,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: remodel,upgrade service,&install generator. 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 1 KVA No.of Luminaires Swimming Pool Above ❑ ln- ❑ No.of Emergency Lighting grnd. grn . 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/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,oras 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: Lance A Macenerney Licensee: Lance A Macenerney Signature LIC.NO.: 11149 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 126A MID TECH DR,W YARMOUTH MA 026732560 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:$250.00 a ^ sk en>2.46 azdocttGvoup---756L-mmvitth4118 ec • ") p yty�� offic-- UseoC- �,Q ernunonweaRof tr/aeeachiaeefie /�'�jC.-Z aR �� B cy e7 Sentient Permit No. .[Jepat6sent of.firs Jenticee • J,1' Occupancy and Fee Checked • �' ~ ' ` BOARD OF FIRE PREV?NTION REGULATIONS [Rev.1/07] (leave blank) .+, -•„_„. 9/ 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: r/Ill6IIR City or Town oft \la(rn o t lk In To the Inspector of Wires: O! By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) I(y) U w r.e Lan e N Owner or Tenant 1'Y1 A c cieCt t rtfI n 'In kr N L Tft 1 s 4- Telephone No. jj Owner's Address • Cr Is this permit In conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) d I Purpose of Building Utility Authorization No. VExisting 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: rash r e.A 03-(,coo. 5eCY i ce c.l- a n1 e 1 ** (;•r'hperiVar- i vI Completion erne followin• table m be waived by the Inspector of Wires. 11� No.of Recessed Luminaires No.of CeiL-Sa addle Fans No.of Total Z sP• ) Transformers KVA C1 No.of Luminaire Outlets No.of Hot Tubs Generators ICVA ' No.of Luminaires Swtmmin Pool Above ❑ In- ❑ No.of Emergency Lighting g Ern& gm Battery Units . No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones Z No.of Switches No.of Gas Burners No.of Detection and Initlatin&Devices I L( No.of Ranges No.of Air Cond. To No.No.of Alerting Devices . of Waste sera Heat Pump Number, Tons•- KW No.of Self-Contained No. Dispo Totals: Detection/Alertiiin Devices No.of Dishwashers Space/Area Heating KW Local 0 Connection 0 Other • 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 0M:tonal detail lfdesired oras required by the Inspector of Wires. Estimated Value of Electrical Work: . (When required by municipal policy.) Work to Starr. 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 0 BOND ❑ OTHER 0 (Specify:) I certify,under the ns andpenalties ofperjury that the Informationand complete. FIRM NAME: idler Electric (1on this application is true,OmQanyLIC.NO.: AIIt�- I Licensee: La nee rn4e Fn P rnQ s Signature e 3 _ LIC.NO.: ("applicable,enter"exempt' in the license manlier line.) Bus.Tel.No:e')R--11 Ste)O 30 Address: kits A N'11 b Tedd P( tilt(MOu. Alt Tel.No.: *Per M-O.L.c. 147,s.57-61,security work requires D tilt( 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. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent- PERMIT FEE:$ OW Signature _ Telephone No.