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Home My WebLink AboutBLDE-18-000391 Commonwealth of Ot'f E..Zrf�7] Massachusetts Permit No. BLDE-18-0003 91 Use Only BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked jRev.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:7/21/2017 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) 74 CAPT WRIGHT RD Owner or Tenant ROLLINS SUZANNE H Telephone No. A w Owner's Address 74 CAPT WRIGHT RD,SOUTH YARMOUTH,MA 02664 /� Is this permit in conjunction with a building permit? Yes 0 No ❑ (Che i., of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o/rs t:t i, New Service Amps Volts Overhead 0 Undgrd 0 ,.....No.o letetpFy/�/// Number of Feeders and Ampacity J ,- !"./ �`V Location and Nature of Proposed Electrical Work: Replacement HVAC �j`� Completion of the following table may be waived by the I or 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 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 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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: Heaters 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 rfdesired 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: Daniel J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 al-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) ❑ owner 0 owner's agent. Owner/Agent . Signature Telephone No. PERMIT FEE: $50.00 4ar Sf 2/17 KC__ (S-P(M',zr artv_fir `ed Fortrme ) X(h A t t y-\ Ccmnwrru of��/ou..rFJeA.-NS _ . —ciaI USC o ii PeraitNo. ,--0 / BOARD OF FIRE PREVENTION REGULA71ON5 Oc icy�Fee Checked vvv Ree'. 1107] Dee Mart) �__ APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in aecorda7c a with the Mesearhtsez axtrical Cod: a 527 C1JA I 2-DO (PLEASE PRINT DV INK OR TYPE ALL ,70RM41701Q) Date: City or Town of: YARMOUTH To the I sector of Wires: By this application the pndersigned eves notice of his or her intention to perform the electrical work described below. r.... .......... ......, Location(Sfeet&Number) ) LK t . Vii. L1 Owner'orTenant QRuao SyLveo, Telephone No. /Li i Owner's Address --� N Is this perait in conjunction with a building permit? Yes ❑ No ❑ (Check App tops sb Bor) Lu I o w Purpose of Eralntaa IItlTlrp Authorization No. V j = Esistinrog Service Amps / Volts Overf cad p New Service Q IInd�.td❑ No.of t�Iet�s w R .a. Amps / Volts Overhead❑ IIndrd ❑ No.of Meters I l t»' c- = Numbs of Feeders and Aarpatdty Location and Nater_of Proposed Electrical Wort. I� ') No. ,rat of Raeased Completion of the joIIowa>table may be waived by the frapertor of n fret. No.of Lumion is No. of Ca-soap.(E12"1")Fars 'Transform= Total No.of Luminaire Omit b'VA NavfHotTabs (Generators • li'VA' • Na.of Ltamfmirne Swims,;..=Pool y-bove ie.- It o.of t'amergeuey l tp.ane osnd. I:I mrd. E Easysv Ur•fm No.of Rersptarle Ots No. of Oil BuLers IME AI..4PkLS 'Nn.of Zones No.of Switches No.of Gzs Rumen LNo.of D-. cdnn and No.of R2l�ves oral otA1ItattitL Devices No.• Air aCoad Tons No.efAlst agDev c s No.of Waste Disposers Seat Pamp Number (Tons I KvC `No,of etfd:ontaiaed Totals: Devi s ,lD = No.of Dishwashers Sp-ace/Area Hestia; KW' li Q Maaiapal Ir Cnanection 0 cyder No.of Dryers Heatea,' v 'Appliances I,rW Security Spsf*ms:` It. No.of Water KW No.of Na of evmr's or Et nfvaleat Heaters No.of (Data Wiring: Suns Ballasts Nn,of Devices or tri alent tNo.Hydromassage Bathtubs No.of Motors Total HP Telecammnnicatioas E sting No.of Devices or Equivalent L OTHER • Estimated Value of Electrical 4JorL /sari'n nes detail tf desired or to required by the Insperlor of Wires. ( WorkEstimated to Start (When required by m„nir,pal policy) Inspections to be reopened in accordance with MEC Rnle 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 incl»i n "completed undersigned certifies that such coverage is in force,and has exhibited proroof of same the eonit issuing office. Theqnivaltnt CHECKONE: INSURANCEBOND 0 OT}IExR 0 (Specify:).) nyder the pains and p ofpalmy,that the information on air o pp&tcotion is true and complete. FIRM NAME: LIC NO.: Lar icenset limble,cues •r" -sz Slgnature(f ,ufaan LIC N0: •t 1n the license number line.) ' Address-;f 1 I : LH < Sus.TeL No_ `Per NLG.L,t. 347, s. 7-61,securitywork ' i aAlt Let.No - g, OWNER'S (NSU retrains Department the Licensee of Public Safety"r License: Lit No. Q required by law. RANGE WAIVER I am awn that the Licensee does not have the liability laminate coverag�l Owner/Agent gtirebylaBy my signature below,I hereby waive this requirement I am the(check one 0 owner owners a eat oil Sten'`- Telephone No. PERMIT FEE: S