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Home My WebLink AboutE-20-243 o• Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001149 •� _ 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:8/30/2019 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 electncal work described below. Location(Street&Number) 11 ARROWHEAD DR Owner or Tenant THOMPSON JOHN D Telephone No. Owner's Address THOMPSON EMILDA A, 11 ARROWHEAD DR,YARMOUTH PORT, MA 02675 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. 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 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. 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.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: DAVID R NICOLL Licensee: David R Nicoll Signature LIC.NO.: 37557 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 144 DRIFTWOOD LN, S YARMOUTH MA 026641038 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 Pe 3 Cr/3 7' 9 M • v.,'ltr:rrrl ,� ^ �+ - '� OccunalIC and r Citect:ec1 E-7 L' r i I 41 BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All wori:so be performed in accordance with the Massacir:revs Eiezo cal Code!MEC).527 R I2.CU (PLEASE PRINT IN INK OR TYP LL INFORMATION) Date: ' a (? _ City or Town of: Ag.K0 C - To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to performthe electrical work described below. Location (Street&Number) /1 Q-o -R D^/\rm Owner or Tenant 3 4 •1 77-(-- M iP-52'` ' Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes !_ No (Check Appropriate Box) Purpose of Building 'Utility Authorization No. Existing Service Amps / Volts Overhead Lndgrd No.of Meters New Service Amps / Volts Overhead _- Undgrd No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: V (i F NE?Ai t l,/fitly't e) / -7--- , YS Completion of the following table may be waived by the Inspector of Wires. r ;No.of Total (No. of Recessed Luminaires !No. of Ceil.-Susp. (Paddle)Fans i' 'Transformers KVA 'No. of Luminaire Outlets (No. of Hot Tubs (Generators KVA Above u In- ; No.of Emergency Lighting :No. of Luminaires (Swimming Pool ilrml ern'.— 'Battery Units No. of Receptacle Outlets No. of Oil Burners ,FIRE ALARMS No.of Zones No.of Switches INo.of Gas Burners ;No.of Detection and Initiating Devices No. of Ranges !No. of Air Cond. Total ;No.of AIerting Devices Tons No. of Waste Disposers Heat Pump., Number ; Tons ; KW (No.of Self-Contained p Totals:! IDetection/Alerting Devices No. of Dishwashers !Space/Area Heating KW !Local MunicipalOther I Connection ;Security Systems:" No.of Dryers 'Heating Appliances KW No.of Devices or Equivalent ',No. of Water No. of No. of ":Data Wiring: Heaters KW I Signs Ballasts No.of Devices or Eouivalent • jNo. Hydromassage Bathtubs INo. 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: 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 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 ' BOND Li OTHER _i ( .ect y:) I certify, under the*t(?ins mid penalties of perjtnr, that the inforntattor- rt this f npiicati :al true and toed te. FIRM NAME: - -' LIC. NO.: 31 t )7 Licensee: Signature , LIC. NO.: • (if applicable, elver "exempt"in the license,umber line.) Bus. Tel. No.: ' i ("r 'at Address: I r ,, , , vlc-,.s <, t,t t, o.. ;t 'i ) x '�:r� � � I Alt.Tel '�; �r "Per M.G.L. c. 147. s 57-61.security work requires Department of Public Safety "S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage normall, required bv lat=. Bs tr,\ signature beiov.I hereby waive this requirement. I am the (check one) _ owner ._ owners agent. O.mer/Acen: S:�r.ature eienhone Na. PER;MII'-FEE: c