The URL can be used to link to this page

Home My WebLink AboutBLDE-19-007224 atE, ,\"' Commonwealth of Official Use Only t. Permit No. BLDE-19-007224 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/N INK OR TYPE ALL INFORMATION) Date:6/24/2019 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) 15 MARION RD Owner or Tenant MARARIAN JEFFERSON S Telephone No. Owner's Address 10 JEFFERSON RD, NORTHBOROUGH, MA 01532 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: Rewire due to fire damage. 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 0 Municipal 0 Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Eauivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eauivalent 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: Stephen M Childs Licensee: Stephen M Childs Signature LIC.NO.: 32325 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 145 CAMMETT RD, MARSTONS MLS MA 026481519 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 0a/ 4A 1 k / -2a.g1/ 1 Cominonrusalth o///(assachusaft's Official Use Only -='-' �7� n ±-imt-- : 2epartmenf of.. ire Serviced Permit No. - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '�,,` [Rev. l/07] ----- (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(AMC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: C/ a U City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) /5 4 q/. IO/ ieC f'f' ��' ct" Owner"or Tenant - �Arlo `/�� ..)-e �/ ,f�C{,e'Cr2(;il Telephone No.,j.61(' 3.20-5.3'3.3 Owner's Address s ce ,yr t' Is this permit in conjunction with a building permit? Yes [ No Purpose of Building ��,�, / �c1JP/� . El (Check Appropriate Box) /,, Utility Authorization No. Existing Service/,e, Amps d2 c-G/i/c> Volts Overhead E! Undgrd t'T ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd s;r 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /�2/De„�,ieGuiv ,;7 .„-. /',? G, Tc dr4 c..�a„ .lU in/t/t �eJe 7LQ C e.f//1r Ch h -(... 74, C.: e, ec/&_a4 Ce(///I 5 lee C e v f c Ce h 17 fr In k i'><c her? Completion of the followingtable may be waived by the ectoor W/4 1'- No.of Recessed Luminaires No,of of Wires.No.of Ceti.-Susp.(Paddle)Fans Total Transformers ICVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmia Pool Above In- an.of hergency Lighting g grad. arnd. 0 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 _,c � • ' Initiating Devices V No.of Ranges No. of Air Cond. Toons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I J KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal _ ❑ Otn� No.of Dryers Heating Appliances , Security Sy meon No.of Water No.of Devices or Equs:* ivalent - No.of Heaters ' No.of Data Wiring Signs Ballasts _ No.of Devices or Equivalent N.- ` No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - �"� OTHER: No.of Devices or Equivalent V ) Attach additional detail if derired or as required by the Inspector of Wires. Estimated Value of Electrical Work: '�/ f v C,.e c; (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 V • undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I certify, under the p,,q5 and penalties ofperjury,that the information on this application is true and complete. _ FIRM NAME: �' ��' ��µ,/? i) /G,pj LIC.NO.:4 ,�..2 .3,2 '� Licensee: S' "y Signature _.. , �?4 ,� LIC.NO.: (If applicableg,entg "exempt in the li ense number ling) 11 . Address./e/t C .7,�e /fc' ��rAy/I'---e. 1/�fiC/� Bus.Alt TeL No.. 'C� c� - �, J "Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety "� TeL No.: eP "S"License: Lic.No. - OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/Agent Signature Telephone No. LPERMIT FEE: $