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Home My WebLink AboutBLDE-19-006978 a* 62V Commonwealth of Official Use Only IIKMassachusetts Permit No. BLDE-19-006978 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:6/11/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertgrm the electrical work described below. Location(Street&Number) 110 SISTERS CIR M Owner or Tenant ROBERTSON DOUGLAS A TRS Telephone No. Owner's Address RYER JANE E TRS,868 WATERTOWN ST,W NEWTON, MA 02465 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: Wiring of garage. 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 No.of Detection and Initiatinc 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/Alertinc 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: 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: DANIEL J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 60e-- C'4Z/t 9 ?)e c wecinjr raf k Com+norcwsaCrfs of///1266aeh th Official Use Only r T„ � l rrei I• fit_ '_ epart ne ct of Permit No. r f 4- fq Occupancy and Fee Checked 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),SZ 12.00 x (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 6 I 0 lCity or Town of: YARMOUTH By this application the detsi ed To the Inspector of Wires: im gn gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 1 t 0 6, 8T'e2 c ciA . Owner or Tenant lh; C 1 fl u") 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 0 Und d gr ❑ No.of Meters New Service Amps _ / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity tN t0•,,, ..,16,,4 g Location and Nature of Proposed Electrical Work: 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 - arnd. arnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS JNo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges Total _ No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump j Number J Tons_j KW No.of Self-Contained • Totals:I I —] Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ o Co nicipal Cnnection ❑ Other � No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent t Heaters ' No.of Data Wiring: - ? No.of Water No.of e Signs Ballasts No.of Devices or Equivalent I.-- No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - No.of Devices or Equivalent OTHER: _ t Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by munici al oli !l Work to Start: p p �') 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. 111 CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) 01 f certify, under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: Licensee: 1 /� LIC.NO.: J�eN `'l '_, iC. Signatur�L ,s,� p (If applicable,enter ex t in the license number line.) "r' LIC.NO.:JCl�4�s �. Address: �$'1 jQ,� yk,�77 _ / Bus.Tel.No.: J Per M.G.L. c. 147,s.57-61,security workrequires Department toof Public Safe "S" Alt Tel No.Svcd_ �o� cense: Lic.No. ee - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norm ally S required by law. By my signature below,I hereby waive this requirement I am the(check one ❑owner , Owner/Agent ❑owner's a ent Signature. Telephone No. PERMIT FEE: $ 75--