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Home My WebLink AboutBLDE-18-004891 Commonwealth of Official Use Only L _ Massachusetts Permit No. BLDE-18-004891 t BOARD OF FIRE 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:3/5/2018 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) 60 CAPT NOYES RD Owner or Tenant HEALY BERNICE F Telephone No. Owner's Address 60 CAPTAIN NOYES RD, SOUTH YARMOUTH, MA 02664-2822 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 P4EY• •rs New Service Amps Volts Overhead ❑ Undgrd ❑ N 4p8 t�s Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel basement area. Completion of the following table may '9 ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of t taal Transformers77 No.of Luminaire Outlets No.of Hot Tubs Generators 'VA 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 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 Siens 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 t#- 6/ 4 (?0t, 'W 'r/z/(l, c.110/2i(c? 6 i r�_ ro rr-0rru,-�f� oil a6�cef lc eL Use O ly '5 _ r/� �• �i Pei...alt No. tg I*1=---1.=" ... cp=rt`m�r-e ofI5ro Jcrvccre aaa�� OccL�ancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS fRev. l/D71 �— (leave blank) APPLICATION FOR=PERM[T TO PERFORM ELECTRICAL WORK .411 work to be pe-,'.or med in accordance wit tic Massachusetts Electrical Code(l C),527 Chia I?DO (PLEASEP?2T INK pP TYPEAT.T INFORMATION) Date: 0 —Q.5 —/a c,� City or Town or: YA RMOUT�I To the Inspector of Tires: ` Ey this applioaboa the ynde,.signed m'ves notice of his or her Lntenaon to perform the elect ical work described below. /\ Location (Street Se Number) 6j 0 cA- l fiO Yes Pomp 5 !/12. 41/ yj�1 /� n 0266 1 Omer or Tenant �O M DI�vYZ 01.V ,.,...,-..,,.. - IUYsR Telephone No. Zz - ?- zo/ uj 1 _ it Owner's Address 5A7n 5 ' o i Is this permit in conjunction with a building permit? Yes E. No (Cher; Appropriate Rot) - Th, l Purpose of Building 04'Mi F/I1II S- ,�e Jl�L4 j SdKgCfs Utility Authorlzation No. l Existing Service /rj-d Amps / Volts Overhead —�..� ,Q �, Urdgrd No. of Meters / I ' 1 New Service d — mPs / Yolts Overhead Undgrd No, of Meters i ..-_._.. i_', Number of Feeders and Ampacitp .._ -•----- - Location and Narare of Proposed Eleatrical Work; 845ext)A:r - Rc GG4-FiwiS/f GuT/46 i C/Ci/i - - — CornpL.tion of the ja cwinz table may be wed by the Irspector o f h'•r- No. of Recessed Lun*hall-es No. of CI-Susp. (Paddle)Fans No.of Total Transformers KVA No. of Lrirnfnaire Outlet No.of Hot Tabs Geaeratnrs KVA Nn. of Luminaires Swimming Pool Above in- ❑ No.or Laiergency Laghong ,rod. and. BawerY IIai`s Na. of Receptacle OutLM No. of ORBurners i.el^H,A.L42MS No. of loam No. of Switches No. of Gas Burners _' kNn.of Detection and Lnifnff Devices No. of Ranges No_ ❑f Air Cond. Tonsl kNn.of Alerting Devices Hemet Pump Number I Tons IKW iNo.of Set n f-Corairred Totals: I I fDerection/AIer'anE Devi No,of Waste Disposers ces No. of Dishwashers Space/Area Heating KW' 1_� R4u nlaal � ❑ CQanection E �� No. of Dryers). Heating Appliances , Security Systems:r No. of Water No. of No.of Data Wo.iring: or Equivalent Heaters 5i�?is Ballasts g- J, No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommanications Wiring: No.of Devices or Equivalent OTHER: k Attach additional derail yrderired or as regizred by the Inspector of Wires. Estimated Value of Electrical Work: if 503' (When required by municipal policy.) Work to Start: 03-0 5 -/9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unles waived by the own r, o permit for the petiormance of electrical work mayissue the licensee provides proof of liabilityinsu. ' g unless • 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, 6, CHECK ONE: INSURANCE E BOND ElOTHER ❑ (Specify:) I certify, rtnder the pains and penrrlrlos of p ury, that the information on this application is true and complete. FIRM NAME: Sol-{k ORov)e - t/o,yr.a OwAigi2 LIC.NO.: Licensee: N k Sic-nature( OAki.,„4,4,14, LIC.NO.: (If applicable, enter "ecempt"in the license number line.) Bits.TeL No.: Address: 5li-jn E 4-60t/i5 , Alt.Tel.No. j 'Per NLG.L. c, 147, s.57-61,security work requires Department of Public Safety"5"License: Lic.No. — OWNER'S INSURANCE WAVER: I am aware that the Licensee does nor have the liability insurance coverage n�— SOmer A en w By my-signature I hereby waive this retluirement I am the(check one) owner ❑owner's agent I a re h Telepone No y o7f6 k PERMIT FEE: