The URL can be used to link to this page

Home My WebLink AboutBLDE-18-002159 Commonwealth of Official use only ` kE ►\ Massachusetts Permit No. BLDE-18-002159 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 PRINT IN INK OR TYPE ALL INFORMATION) Date:10/11/2017 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) 165 DRIFTWOOD LN Owner or Tenant PAULSEN JAMES S Telephone No. Owner's Address PAULSEN SUSAN C,8926 MEGAN AVENUE,WEST HILLS,CA 91304 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 0 Undgrd 0 Ryten ew Service Amps Volts Overhead 0 Undgrd C}� . ,.. file :/i _ Number of Feeders and Ampacity �7rT `///Iw�,[J///7O Location and Nature of Proposed Electrical Work: Wringfor boat dock. /v/r�//(^/ p Completion of the following tablemay` 1 -IN I cto� � No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tal Transformers A 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 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 ❑ 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: !teeters Signs Ballasts No.of Devices or Equivalent No.Ilydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail fdesire4 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: Arthur P Doherty Licensee: Arthur P Doherty Signature LIC.NO.: 17197 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:372 YARMOUTH RD, HYANNIS MA 026012043 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 OR 4(4 e 'e a Commonwealth yy l� g4 Commonwealth o1 i//amacLaselle Official Use Only `vN `, • --2.—( /� II c2 Permit No. k ,�rye ThIPMtment(/gins�eWicee �� - Jr, ; Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 e) (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /O/jam//7 City or Town of: ]H p To the Inspector of Wires: By this application the undersigned glad-Mee of his or her intention to perform the electrical work deserted below. Location(Street&Number) /41C 1 r(P/-i,q Off I—an e- V) Owner or Tenant t t i.e Telephone No. d Owner's Address gqato mein t i A te. wig7k ' quo 1 -Q Is this permit in conjunction with a d8llding permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building PSI it( Utility Authorization No. Existing Service_ Amps / Volts Overhead❑ Undgrd❑ No,of Meters _ New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampactty Location and Nature of Proposed Electrical Work: U1l C{tilt o-c dock V - Completion of the following table m be waived by the Inspector of Wires. W No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans No.of lots! Transformers KVA QNo.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingAbove In- No.of Emergency Lighting Pool Brod. 0 grnd. 0 Battery Units J No.of Receptacle Outlets No.of OB Burners FIRE ALARMS No.of Zones No.of Switches No. f Gas BurnersNo of Detection and 2 o Initiating Devices IQ No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 1sIo.of Self-Contained Totals: Detection/AlertingDevices No.of Dishwashers Space/Area Heating KW Local0 Municipalnnection 0 Other Co 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: 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 issuinoffice. CHECK ONE: INSURANCE% BOND 0 OTHER 0 (Specify:) bowl i eta 4 D''Jet l I certify,under the pains and penalties ofperf ury,that the information on this applied; is true a•d complete. FIRMNAME: j�� . 1 I s I t # CP ,. i t s: .4(7/97 Licensee: a ei1lllatratb s . '. V , Signatures 'Cilir/ --rt.s.: (if applicable,enter"exe pt' in the lice s mmm.t r line.) 4 s.Tel.No. -77/- 7R7 Address: ,37.2- Ara)butt.- ' e Ifij4p/it c AM Dabo/ AIt.TeLNo.:SV - roil- .3� *Per M.G.L.c. 147,ss57-61,security work requires Department of Public Safety"S"License: Lir.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 require entr l am the(fheckmte)'J arer 0 owner's agent. Owner/Agent R E ( C i Signature Telephone No. .PERMIT FEE:$ 50,00 OCT 11 2017 ,i MiCl3'U Cr'ARTM cNi