The URL can be used to link to this page

Home My WebLink AboutE-18-3603 r, ISMCommonwealth of Official Use Only IS Massachusetts Permit No. BLDE-18-003603 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ••' [Rev.1/071 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:12/19/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 355 BUCK ISLAND RD Owner or Tenant DOLORES KRISCO Telephone No. Owner's Address 355 BUCK ISLAND RD,WEST YARMOUTH, MA 02673 /_�+Jj//��e¢��.�` Is this permit In conjunction with a building permit? Yes 0 No O. (Chej�W , 'rrop___rf te4Zu�t Purpose of Building Utility Authorization No.`_ � Q Existing Service Amps Volts Overhead 0 Undgrd 0 `..s` e A New Service Amps Volts Overhead 0 Undgrd 0 eft A' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: move switches in kitchen,add circuit for refrigerator, add isla d eit,s....\(508-320-0841) ],/ ,9 < Completion of the following table lie i4ived byx r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of tat Transformers A No.of Luminaire Outlets No.of Hot Tubs Generators _ KVA No.of Luminaires Swimming Pool Above 13In- 13No.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas BurnersNo.of Detection and • Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices 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.Hydromassage Bathtubs No.of Motois 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 ❑ . OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. ' FIRM NAME: William Sinclair . Licensee: William Sinclair • Signature LIC.NO.:. 18210 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 180 SOUTH MEADOW RD, PLYMOUTH MA 023608901 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 ❑ owner's agent. Owner/Agent Signature Telephone No. !PERMIT FEE:$75.00 • l_emmorsmeaflh of///eidrt4 ti±.4 Ofneisl Use Only gam_— f � ,&DE 4'--GO.,? 3 �t•`��, PermitNo. -1JcParli»rnf o crviaM �_ 4 BOARD OF FIRE PREVENTION REGU REGULATIONS Occupancy and Fee Checked at.-Rev. 1/072 - 4 • APPLICATION FO.RJPERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordance with the Massa:hostas Electrical Cod;(MEC),$27 OMR I LH (PLEASE PRINT IN INr OR TYPE ALL INFORM,QTION) D ate: 1_a �7 City or Town of: YAMQUTH To the Inspector of Wires: By this application the pndesiped gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 35-5 73✓C(c— S4-a--rN Owner'orTenant polo r,c 11(IISCa Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes r No ❑ (Check ApproprAppropriateBoz) ' . Purpose of Bntlamg Utility Authorization No. `` ,A� Existing Service_ Amps / Volt Overhead E Dndgrd❑ No.of Meters _ '(` - New Service __ Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity • 0 ]fj Location and Natur_ofProposed ElectricalWork^. /r.Ocif SwrrfZ6 4 tiTdfv/ .4,1b W r (4rtatT ,`I!r 11 7cto / /-/ �i/C� N co-.. Completion ofthefoffonto table may be waived by the Irsnrlor of irrm It No.of Recessed Lnn:r,•f-es Na of Cet1-Srsp.(Paddle)Fzas INo,of Total W .--r r 1 Transformers R'VA No. ofL r++' e Outlets U Na.of got Tn6s V 1 ICs-aerators • FCVA ' No.of Luminaires Above In- No.vi> me-;� e llJ 0l t Swim ming Poo! ❑ cyt-Shpng -, ora3 arnd. Ifiawery l7aits v 15 . No.of Receptacle Outlet: . No.of Oil Burners 'FIRE ALASMS INo.of tots • -- No.of Switches No.of Gas Burners Na of Dete^.noa and No.of Ranges l atal Inrtxa�'Devices No. of Air Cond. Tons No.of Alerting Devices • Heat Pump I Number 'Tons I KWINo of Self-Contained Totals: J Detetion/Alertne Devi No.of Waste Disposers ces No.of Dishwashers Space/Area Heating KW' Municipal Local❑ Connection ❑ Othr No.of Dryers Heating Appliances KW Security Systems:* No.of Water RW No.of Devices or Equivalent Heaters No. of No.of Data Wiring vt Sins BallastsNo.of Dev ces or Equivalent o� No.Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring•. — Na of Devices or EcLt ivalent ‘ii O1liL'^n.' • Attach additional detail Vdesired, or as required by the Inspector of Wirer. ' Estimated Value of Electrical Wori (WhenWork to St?rt: required by municipal policy.) X41 sf/f 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 d`; the licensee provides proof of liability insurance including"completed operation"coverage or it substantial equivalent The 4,1 v undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE a BOND ❑ OTHER 0 (Specify) I certify, under the pains and pennhlas ofperfwy,that the information on this application is true and complete. . FIRM NAME: , ten. C „. .,_f F. % I c/ X e O.• lYc�-(Q v Licensee: f/(f r ?,,iC / Srt applicable,w 9 �yOl u/ Signature Al�/ / lir 0.: (7f enter "¢empt' ' the licerue number I' e.) � rBus.TeL No. � cf/V-1. Address: rr. yK+r �U y Alt.TeL No.�—'J "Per M.G.L. c. ]47, s.57-61,security work requires Department of Public Safety"S"License: LicNo. • cc OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor hove the liability insurance coverage S required by law. By my signature below,I herebyy , Owner/Agent waive this requirement I am the(check one 0owner 0 owner's a eat normally Sig-nature Telephone No. PERMIT FEE: $