The URL can be used to link to this page

Home My WebLink AboutBLDE-19-001864 4- op set Commonwealth of Official Use Only O _ Permit No. BLDE-19-001864 Massachusetts 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:10/1/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ot his or her intention to pertorm the electrical work described below. Location(Street&Number) 110 SISTERS CIR Owner or Tenant ROBERTSON DOUGLAS A TRS Telephone No. Owner's Address RYER JANE E TRS,868 WATERTOWN ST,W NEWTON,MA 02465 n Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box)Q�/b e/ Purpose of Building Utility Authorization No. Z ci Q ( c �W ,t Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters 1.5%) New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence 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 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 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$180.00 t gVi(le. 5pm r- r 1 mik...-6-ocfiz, £4 min,) /,2/(/ Commonwealth of//lassac its ,. • Official Use Only `� Permitv No. O*/1 1".- :-,-.10i--_-,-.f, ///�� .i f = Apart-mad m al gip.serves .. S BOARD OF FIRE PREVENTION REGULATIONS [Re 0 cY and Fee Cnk) C (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I All work to be performed in accordance with the Massachusetts Electrical Code I C),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT IOII9 Date: 7 . / 5- City or Town of: YARMOUTH To the I •ector of Tres: By this application the Indersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) / I 0 S ►ST.c,t._s c' cAri l „QvkQ„ H (wner or Tenant c-,� n A. T R�i►r. , Telephone No. Owner's Address ' 1 `." Il this permit in conjunction with a building $ > a permit? Yes ❑ No ❑ (Check Appropriate Box) _..: s ` Purpose of Building Utility Authorization No. 11.I . ::J fisting Service Amps / `�°\\FI'��,` ; p Volts Overhead 0 Undgrd❑ No.of Meters �' �-�'t� lyjew Service i C ;t\ c 2QL Amps ?2.D 1 Z.YbVolts Overhead❑ Undgr4 No.of Meters _�_ a� Nitmber of Feeders and Ampacity I_ .. ____,_..__ ration yard Nature of Propos Electrical Work: t-4l� � cs✓,A,u 1 c,.s 4 F: ....,i e�iv,. . .3 tv.i° L D/L. rhdete hp.,,-.c t-.2 i.pyr'�T,rig I3q".‘9y`�-9 Completion of the following table may be waived by the Inspector of Woes. No.of Recessed Laurin ' No.of CeiL-Busy.(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 - grad. grad. 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. Tons No.of Alerting Devices iNa No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained II Totals:I I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Monnectiounicipal Cn ❑ °ther 1` No.of Dryers Heating Appliances KW Security Systems:* NNo.of Data Wiring: No.of Water No.ofNo.of Devices or Equivalent Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs Telecommunications Wiring: No.of Motors Total HP OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) 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 il undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. vil CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certify, under the pains penalties ofperjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee:�,,,�1,L �:�• 1-`- Signature(-13,,.....Lel(fa (If applicable,enter" empt"in the license number line.) LIC.NO.:�(�� j Addres . ZH n � ,:< Bus.Tel.No,: Jf Safety V Alt.Tel.No.:.i�i�St'T?L . ls�_ "`Per M.G.L.M.G L c. 147,s.5 61,security work requires Department of Public "S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner ❑owner's a:ent. Owner/Agent Signature. Telephone No. PERMIT FEE: $ /. A I' ..- 1 / ,...,., ,, „ <' / a !O'. \ c? N,) \ '',.-;•., '-'1'/Q. \ •I\ cz,>> \\, ,,-, -,,,, \ 4, , .. . : • • __ ..