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Home My WebLink AboutBLDE-19-003719 4 �� O Commonwealth of ISA Use Only Fife Massachusetts Permit No. BLDE-19-003719 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.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 PR/NT/NINK OR TYPE ALL INFORMATION) Date:12/19/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform t e c ectrica work dpsgr'bed below. (Street&Number 408 NORTH MAIN ST �[ `��CO Owner or Tena nt= Nitres Telephone No. Owner's Address W_OQQ MARIE-E7 408 NORTH MAIN STREET,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 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: Replacement furnace 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 Ilot Tubs Generators KVA No.of Luminaires Swimming Pool Ab0 In- I:1No.of Emergency Lighting grnove d. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiative 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: Defection/Alerting Devices No.of Dishwashers Space/Area Healing KW Local 0 Municipal 0 Other: _ Connection No.of Dryers Heating Appliances KW Security Systems:' No.of Devices or Equivalent No.of Water ICW 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,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: DANIELJPECKHAM Licensee: Daniel J Peckham Signature LTC.NO.: 26830 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 it 'JG Lt Telephone No. PERMIT FEE:$50.00 qA._ ,(., Itq D /87(4' rt I 0.sts z ii l.onunoruor¢ o��/aie¢a/atwfls ices Official Use Onl 00 1� =_V' Permit No. o f~ 1 - artmsn(o 2_ �7rnv. ^" N H n. 1 = r `lin /07] l HI cn 'iw - ` BOARD OF FIRE PREVENTION REGULATIONS Oc. 1and Fee Checked IQ 1 ,--f o . 1/07] (leave bleak) w ,3 ! APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK I w u 'o I All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 ^°" ------.1= (`LEASEPRINT IN INK OR TYPE ALL INFORMATION) Date: I,h j /jam City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice o/f,his or her intention to�qrm the election/"log' d ed clow. . Location(Street&Number) 41h g- nLAC.u„ zN (�� ST /V ` 'Cif( Owner or Tenant m; lec - e*A.A.”.e.a Telephone No. Owner's Address Is this permit in conjunction with a buBding permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Und gid❑ No.of Meters New Service Amps / Volts Overhead 0 Und rd L 0 No.of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work: “ii A.. R cin/c< N.✓nT fi t nca G K Completion of the followinttable may be waived try the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans No,of Tota! Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above ❑ In-?incl. ❑ loft.oseryUt.mergency Lighting grad. nits 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. Ton No.of Alerting Devices - • No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Mal Connectionunicip ❑ other - No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KW No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 1, No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: - • Attach additional detail if desired,or ar required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) t e Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. V 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: INSURANCE0 BOND 0 OTHER 0 (Specify:) 1 cemfy,under the pains and penalties of perjury,that the information on this application is true and complete. r) FIRM NAME: ) -S, LIC.NO.: Licensee: ,47_ Tee-Leon Signature Ce, .:: aoLIC.NO. • (If applicable,enter"esetnpt"in the license number line) C am tO t Address <t el fl c* y 5 / mit es77,ws H,;3/4/.../.5 9 Bus.Tel.No.�_ Alt.Tel.No.:6_2� t��3�, J `Per M.G.L. c. 147,s.574 1,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 t Owner/Agent j Signature Telephone No. ( PERMIT FEE: $