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HomeMy WebLinkAboutBLDE-19-002142 • Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002142 . BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked tRev.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 WINK OR TYPE ALL INFORMATION Date:10/10/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonn the electrical work described below. Location(Street&Number) 19 PEBBLE BEACH WAY Owner or Tenant FLYNN HOWARD R Telephone No. Owner's Address CUTLER JENNIE M, 19 PEBBLE BEACH WAY,SOUTH YARMOUTH,MA 02664 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: Plugs&switches Completion of the following table may he waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers t KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: William L Wolaszek Licensee: William L Wolaszek Signature LIC.NO.: 28768 &applicable.enter"exempt"in the license number line.) Bus.Tel.No.: Address:96 CAPTAIN LOTHROP RD,S YARMOUTH MA 026642818 Mt.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 ❑ owner's agent. Owner/Agent Signature / Telephone No. PERMIT FEE:$75.00 )Qct (A (« (I1 k L Ll( ( /s (Rtcr_iiuc 9-00 >). ono Commonwealth ye. O' c'• Usc Only � I !� t-ammanwraUh o�/rtaaaac�iruatta Z L.11� t g4 qpirly4z ; _ 2)rpartment el Jin&mica Permit No. sin Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. I/O 7) (leave blank) ill APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 5, 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR/4MATION) Date: /0 4 Y City or Town of: c.f yno.ITo the Inspector of Wires: By this application the undersigned givesqnotice of his or her inte•�,�tion to perform the electrical work described below. Location(Street&Number) f l ?ebble VsegCIS. ti-)c-•/ I Owner or Tenant N 0 U313.< %. F 1y in vv Telephone No. Owner's Address • Is this permit in conjunction with a building permit? Yes 6 No ❑ (Check Appropriate Box) , Purpose of Building Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd❑ No.of Meters _ New Service _ Amps / Volts Overhead❑ Undgrd 0 No.of Meters _ Number of Feeders and Ampacity / r �j Location and Nature of Proposed Electrical Work: 't1 /ecc .j 3 T (5S O h e 55 RdS a Nl Reis Completion of the fallowin•table mo be waived by the Insppeector of Wires. Vi tib p (Paddle)Fans No.of Recessed Luminaires No.of Ceil.-Sas No.or Total C, Transformers KVA © No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting -t No.of Luminaires Swimming Pool grid. LI 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 V. Initiating Devices l 1.1 No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers 'Heat Pump Number, Tons KW Na.of Self-Contained F Totals: " Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Qiber Cyonnectton No.of Dryers Heating Appliances KW Security No. f 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 No.of Devices EWiring:ivalent _ OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Q .,� :stimated Value of Electrical Work: l0°' (When required by municipal policy.) , Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. W m s INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless > -Si 'cc � he licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The N a i 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 Cl (Specify:) ___ toQ�\:HECK under the pal and penalties of perjyry,that the information on this application is true and complete. pIFIRMNAME: kJJ%1N\C%,.., t )•J0l e.S7er` LIC.NO.: g 76 1Q Licensee: V./\k\Z,ew L OleiS?Le t SignatureC� LIC.NO.: if applicable,enter"exempt"in the license number line.) Bus.Tel.No.•S6 V 560, 64 S 9 Address: Alt Tel.No.: 76 o q 41g 'Per M.G.L.c. 147,s.57..6 I,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 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/AgentPERMIT FEE:$ Signature Telephone No.