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Home My WebLink AboutBLDE-18-00816 Commonwealth of Official Use Only ' Massachusetts Permit No. BLDE-18-000816 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.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:8/10/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the electrical work described below. Location(Street&Number) 2 CHRISTOPHER HALL WAY Owner or Tenant DRISCOLL MICHAEL F Telephone i 1 Alb Owner's Address 2 CHRISTOPHER HALL WAY,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ No 0k Purpose of Building Utility Authorization No. n ,(( , /� 1.0 �" Existing Service Amps Volts Overhead 0 Undgrd 0 r.t�-V New Service Amps Volts Overhead 0 Undgrd 0 No.ofi •• i Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Relocate wiring due to vaulted ceiling. /')C J Completion of the following table may be waived by theInspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)FansNo.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above 0 In- CINo.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. TTotal No.of Alerting Devices n No.of Waste Disposers 'Ileat Pump Number , Tons jKW ,No.of Self-Contained Totals: Detection/Alerting 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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 tenth?,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Robert W Pierce Licensee: Robert W Pierce Signature LIC.NO.: 12359 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 FOSTER RD, E SANDWICH MA 025371040 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: $75.00 / g I'dc7Y� u.cat. ` t-ni t 71 `• ` .�.1 -� l-ommnnluealLs of ase hy�•eL� eisl USC O¢ly - - -9 /�� 1 \r� .1.Permit No. QM,•^�'Z I =-{�� apar6r-ens o Serviced r W o BOARD OF ARE PREVENTION REGULATIONS Occupancy lJO •andF blk)Checked g's ¢ t Rev. lro7) (leave blank) o W APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK W n All work to be performed in accordance with the Massachuseoi Electrical Code o ¢ O (MEC),027 CNilt 12DO o (PLEASE PREATININK ORT1PE ALL INF'ORMITIO ) Date: Ill d City or Town of: YARMOUTH To she Inspector of Wires: w m m y this application the undersigned gives notice of his or her intention to perform the electrical wort"descnbed below. ocation (Street&Number) U Owner'orTenant //)/t r . r S ' ( V ' t r oAr Telephone Na. Owner's Address —___________ Is this permit in conjunction with a building permit? Yes C' No ❑ (Check Appropr atm Boz) ' Purpose of Bolding (t.S __ Utility Authorization No. Existing Service /60 Amps /Z. Ina Vols Overhead " Undgrd❑ No.of Meters _L New Service Amps / Volts Overhead❑ Und d 0 NO.of Meters Number of Fders and A apadty • Location and Nature of Proposed Electrical Work. retook(dares T®l thew f/_ 0 Ct /6, Completion of the followrnt table may be waived by the Inroector of Wires, No.of Recessed Lamres inziNo.of Ca..-Sasp.(Paddle)Fans INo.°f Total Transformers ICVA Na. of Luminaire Outlets No.'of Hot Tubs • ILCrenerators . I.'VA ' • Na. of Luminaires Swimming Pool Above ❑ la- ❑ leo.ox t,mergency Lanza?.erns. IBattery Units • No. of Receptacle Outlets No.of OB Burners E7'TRE ALARMS INn.of Zones No,of Switches No.of Gzs Emmers Na,of Detection and No.of Ranges No. Devices Nn.of Air Caad. 1° No.of Aiet•tmg Devices Tots No.of Waste Disposers Heat PumpINumber (Tons IKW IND.of Self-Contained Totals: J lDerefion/Alertino Devices No.,of Dishwashers • S acdArea Heating KW' Maaiapal - F Local❑ Connection 0 Other No.of Dryers Heating AppliancesSecurity Systems:* KW Q No.of Water No.of Devices or Equivalent 4. Heaters KW No. of No. of Data Wiring Sian Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No. of Motors Total Hp Telecommunications Wiring: Na of Devices or Equivalent OTHER - • • R Estimated Value of Electrical WorkAttach additional detail if desired or m required by the Inspector of Wires. Work to dValbit f C fiOP (When required by municipal policy.) , 3 WorkINSto.NCE CO GE: moons to be requested in accordance with MEC Rule 10,and upon completion. GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance inching"completed operation"coverage or its substantial equivalent The spiders geed certifies that such cov9geisin force and has exhibited proof of same to the permit issuing oEce. CHECK ONE: INSURANCE DI BOND 0 OTHER 0 (Specify;) J I ter*, under the P andemetics of pen d the infori tcEan on this app&¢tion is bite and campfde. 91 FIRM NAME: 1D p b (c t t2_ tV'it. LIC.NO,:JZ3clrB Licensee: -1,1., 9 3 I� '�'-- Signature LIC.NO• En,.. L (7fcpplicnble,enter"exempt"in the license number line) r Address. 12 Ft,S � Ref C n Sns.TeL No. 1 zz 3'L j �'—+. �n i D ab c3 Alt Tet No.. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.No. Q OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Srequired e ed by l w. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 ownc's agent Stgnatnre Telephone No. 1 PERMIT FEE: S