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Home My WebLink AboutBLDE-18-003209 Commonwealth of Official Use Only E4 ,�,►% Massachusetts Permit No. BLDE-18-003209 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:11/30/2017 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) 46 GINGERBREAD LN Owner or Tenant KLUG STEPHEN L Telephone No. Owner's Address KLUG MARY MARGARET,46 GINGERBREAD LANE,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • • .r/ . m x) Purpose of Building Utility Authorization No. N. Existing Service Amps Volts Overhead 0 Undgrd 0 's o i , '►p New Service Amps Volts Overhead 0 Undgrd 0 i �2tfr+ A. Number of Feeders and Ampacity 0 Location and Nature of Proposed Electrical Work: Rewire existing garage. 1/ n Completion of the following table may be w iv y s r of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of � sial Transformers CI /I��77 e A No.of Luminaire Outlets 5 No.of Hot Tubs Generators A No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battens Units No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 5 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tool 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 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: Heater Signs Ballasts No.of Devices or Eouivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eouivalent 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: Brian A Smith Licensee: Brian A Smith Signature LIC.NO.: 24307 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:20 GELDING CR, BARNSTABLE MA 026301503 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 Com}&4 ( 2r/i7 -.L.\ l-ommanwea&of///addachutdeffd Official Use Only '!: c7ro&(� Permit No.Thparfmsnf o fJirviced• Occupancy and Fee Checked --y � _ BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07] . (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIOII9 Date: 4/30//7 City or Town of: YARMOUTH To the Inspector of Wires: ` • By this application the pndersigned es notice of his or her intention to perform the electrical work described below. 41 Location(Street&Number) , (Z# CL-c ea. ,4t/ 0 ��` I Owner or Tenant ‘..4.7,21.4--- -422.-V Telephone Na. W r..... '4' I Owner's Address ,..0,j99G Y >h I ef � Is this permit in conjunction with a building permit? Yes [� No El (Check Appropriate Boz) a . W , cPurpose of Building U,..tilit/y Authorization No.c..) 8( Existing Service Alb � Amps /1d 1_,k) Volts Overhead ij� Undgrd❑ No.of Meters ' 1 Z New Service Amps / Volts Overhead❑ Undgrd 7 , ,7 ❑ No.of Meters • Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: .[li4iv/ sk49 6'?- LX/.STINy' e 4 ?7 4 Completion of the following-table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Cet1 Susp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators • KVA • No.of Luminaires Swimming Pool Above ❑ Ionr-nd. ❑ Naott.o �, rUnirtgsency Lighting - No.of Receptacle Outlets 7 No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and - ' Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons I KW No.of Self-Contained - v Totals: Detection/Alerting Devices \ No.of Dishwashers Space/Area Heating KW' Municipal Loco!❑Connection ❑ Otfie No.of Dryers Heating Appliances KW Security Systems:' No.of WaterNofit Devices or Equivalent Heaters KW No.of No.of Data Wiring V Ballasts Signs No.of Devices or Equivalent ,( No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: �Y No.of Devices or Equivalent OTHER: - Attach additional detail ifdesired oras required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) 1 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 t 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 pd and penalties of perjury,that the information on this application is true and complete. FIRM NAME: i /77/ h" _� LIC.NO.: ;� Licensee: ,y/h1//" Signature iiY/ �" .NO.: (If applicable,enteral-.empt'•in the titans n her li i` ,�� , Bus.Tel.No.• _ 9 Address: ) ' 4 Alt.Tel.No.: j 'Per M.G.L.c. 147,s.57-61,security work requires Department of'Public Safety"S"License: Lic.No. QOWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5required Owney llit aw. By my signature below,I hereby waive this requirement. I am the(check one)El owner ❑owner's agent Signature Telephone No. I PERMIT FEE: $