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Home My WebLink AboutBLDE-19-003657 d Commonwealth of Official Use Only fE Massachusetts Permit No. BLDE-19-003657 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 PRINTININK OR TYPE ALL INFORMATION) Date:12/17/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomr the electrical work described below. Location(Street&Number) 173 SILVER LEAF LN Owner or Tenant LOUGHLIN JUDITH D Telephone No. Owner's Address 173 SILVER LEAF LW,WEST YARMOUTH, MA 02673 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. 2311931 Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service. 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 PoolAbove ❑ 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 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 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: Jack W Griffin Licensee: Jack W Griffin Signature LIC.NO.: 418 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 JOANNA DR,S YARMOUTH MA 026641339 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 riWIZCOKicznrAtS, A ik1.3 _� l.aminORfaI6 Of 4U4C 4L! Official Use .• ervrcel O ` 3 Only .., , mid �� o/ s PemutNo. c "�`'_ ' J Occupancy and Fee `- BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07j (leave blank)ked APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 I (PLEASE PRINT IN INK OR TYPE ALLINFORMATIOI) Date: ,Z/o//l76 , _._ City or Town of: YARMOUTH To the Inspector of Wires: '—J . By this application the undersigned gives notice of his o her i tention to perform the electrical work described below. Location (Street&Number) X 73 SI i✓eK/N J'.gr+-c. —4OwneforTenant -rlJd Lou ,I, IA Telephone No. n' 's Address 5/11W--4..- ill co Ili permit in conjunction witb a building permit? Yes ❑ No _ n (Check Appropriate Boz) `" Pijrp se of Building / f tq y 1 Utllity Autfiorization No. 0?3//9J/ EuIstl Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters V W New ervice 9O0 Amps /26 /„zy6 Volts Overhead Und / L L f cm gid 0 No.of Meters I�um r of Feeders and Ampacity i C4 Location and Nature of Proposed Electrical Worts: up 6046t- Se&V1 CC) 76 old e A I Completion of the followin&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Col.-Snsp.(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.otE.mergency Lighting - t:rnd gm& 0 Battery Units No.of Receptacle Outlets No.of Oil 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. To s No.of Alerting Devices *.y.74 No.of Waste Disposers Heat Pump I Number [Tons I KW No.ofSelf-Contained Totals: I Detection/Alerting Devices • V No.of Dishwashers . Space/Area Heating KW' oa Lf Municipal ❑Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* : Heaters 6 No.of Water No.of No.of Devices or Equivalent KW No.of Signs Ballasts Data Wiring: Q/ No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - 1U No.of Devices or Equivalent Y OTHER: - Attach additional detail ifdesired or as required by the Inspector of Wires. .0 Estimated Value of Electrical Work: (When required by municipal policy.) l work to start:/�2//Y//r Inspections to be k1 � requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless 4 the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The C,: undersigned certifies that such cov7te is in force,and has exhibited proof of same to the permit issuing office. ` Z' CHECK ONE: INSURANCE Cr BOND 0 OTHER 0 (Specify:) Vr I cerafy,under the pains and penaltieitof perjaty,that the information on this application is true and complete./A FIRM NAME: rjede G-t E' ,J LIC.NO.: /v/ie W /Licensee: y- l tt 't UC G I Eli rJ Signature � LIC.NO.:E /9 11 (Ifapplicable,en r"exempt"in the license numb r line.) ..}�, Bus.Tel.No.: 97♦^•Y79• �� Address. U4ANNq roc ,$7,tT5, `frgenluw/., /4.M ed4 y J 'Per M.G.L.c. 147,s.57-61,security work requifes Department of Public SafetyAlt.Tel.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 hereb Owner/Agent Y waive this requirement. I am the(check one)0 owner El owner's agent Signature. Telephone No. I PERMIT FEE: $ �� I