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Home My WebLink AboutE-19-4090 os es of Official Use Only vs BOARD OF FIRE Permit No. BLDE-19-004090 �--' RE 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:1/11/2019 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) 20 PAYSON PATH Owner or Tenant COUGHLAN CLARE C Telephone No. Owner's Address 20 PAYSON PATH,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement burner. . Completion of the following table may be waived by the Inspector 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 Ab ❑ • In- CINo.of Emergency Lighting grnove d. . 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. 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 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 Stens 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: 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 ❑ (Specify:) • • I certify,under the pains and penalties ofperfury,that the information on this application is true and complete. FIRM NAME: DAVID W SPRINGER - Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 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: $50.00 Q (/( f,'9 ,2_ c, w. r , � t-an/7mnsoruuraLth[, yy o f //aisacff! Official Use Only Apartment 01` .ire Sry s Permit No. l (Cit14 Oat err- t-.1 Occupancy and Fee Checked I • BOARD OFFIRE PREVENTION REGULATIONS 'Rev. 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Code(TMEC) 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE 4LLINFORMATION) Date: 1 /11 ( 1 City or Town of: YARMOUTH To the Inspector of Wires: — 0 r- --IFF i By this application the undersigned gives notice of his or her intentionto1` perform the elechical w rk desrnbed below. W rn I1 Location(Street&Number) ZO tll{{SU,S e&.1 tr (IJ YaC"o utt, > c �¢ OwnerorTenant J7e.c.€ (,Shi--A� 1 -- eV 1< I ' Telephone No. ! Owner's Address W .-a Cu, V IZ i Is this permit in conjunction with a building permit? Yes �J1 ❑ •-• (Check Appropriate Box) o Purpose of Building ( }[I W Utility Authorization No. s 5 Existing Service Amps / Volts Overhead Q Undgrd❑ No.of Meters tot New Service _ Amps / Volts Overhead 0 Undgrd 0 Nd.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: .Ret,):it (3ur&tr Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires Na.of Cet7.-Susp.(Paddle)Fags No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming pool Above In- Na.of E-mergeacy Lrghung - `end. ❑ d. ❑ Battery Units No.of Receptacle Outlets . No.of Oil Burners FIRE ALARMS INo.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 No.of Waste Disposers Heat Pump I Number ITons IKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municip 'I❑Connectioaln ❑ Other No.of Dryers Heating Appliances KW Security Systems: No.of Water No.of No.of Devices or Equivalent No.of - Heaters KW Signs Ballasts Data Wiring No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: _ Attach additional derail if derired or as required by the Inspector of Wires. Estimated Value of EIqctrical Work H W (When required by municipal policy.) Work to Start 1 /°l/1q 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 i ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covers is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: • ( . I G{-(' \ LIG NO.: til 7 d A Licensee: �( j r W. n' -ran Signature ems` LIC.NO: 323 9 (If applicable,enter"exempt" n the fir" e number li ) Address. in (i�d S V(, t J Bus.Tel.No.• u$ a 131 J 'Per M.G.L. C. 147,s.57-61,security work require rivii Alt.Tel.No.: ry quire Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER,, I am aware that the Licensee does not have the liability insurance coverage normmally required by law. By my signature below,I hereby waive this requirement I am the(cheek one)0 owner 0 owner's a t Owner/Agent Signature• Telephone No. ( PERMIT FEE: S