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Home My WebLink AboutBLDE-19-001290 o! Commonwealth of Official Use Only irLitili Massachusetts Permit No. BLDE-19-001290 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:8/31/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 19 BENNETT AVE Owner or Tenant ODONNELL MARILYN A Telephone No. Owner's Address 85 SAINT AGATHA RD,MILTON, MA 02186-4336 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: Service upgrade&interior replacement of switches&receptacles. Completion of the following table may be waived by the lyspector 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 Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers (�(» Totals: Detection/Alerting Devices �w No.of Dishwashers Space/Area Heating KW Local ❑ Municipal 0 Other: Connection c., No.of Dryers Heating Appliances KW Security Systems:* e" No.of Devices or Equivalent E.No.of Water KW No.of No.of Data Wiring: C. 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 ifdesired,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 perjug,that the information on this application is true and complete. FIRM NAME: Robert W Pierce Licensee: Robert W Pierce Signature LIC.NO.: 12359 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 FOSTER RD, E SANDWICH MA 025371040 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:$250.00 c_”40-11„,S3 0</( ,e. , t4 31( 549 t. cts.V._-s, to K -.. a•munonwealth off"/' a<hucssffs Official Use Only �Ir=__ cx & 9 '- ,Zq 0 s+! = ..UepServiced Permit No. =- BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked -- i •ev. 1/0 eave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts Electrical Code WORK (PLEASE PRINT IN INK OR TYPE ALL INFO �`��>527 CMR l 2.00 rv, INFORMATION) � � ® City or Town of: �'ARMOUTH) Date: Inspector 3v r By this application the p¢tdersigned groes notice of his•r her in ention toUJ perform the 11, Toelectrical ' s±of Wires: WLocation(Street&Number) t� 3e. Ibelow. aOwner or Tenant C``�'® I �'� �a fwo Owner's Address r u �� 71� �7:��elephone Nofr2 (,� z Is this permit in conjunction with a buildin ? d' vi I p o g Pmt• Yes (� No ❑ (Check Appropriate uj 1 V, Purpose of Building e c L._____ _ ________ PP Priate Box) Utility = thorization No. T. , 1 LeLILExisting Service 7Up Amps (Z.v _ ._........,.. -L-- iu Volts Overhead aj Undgrd❑ No.of Meters f NewService 10 0 Amps ZO/Z Y6 Volts Overhead Number of Feeders and Ampacity Undgrd 0 No.of Meters _� Location aNature of Proposed Electrical Work: C.J./►.do i i'L•,- end e1C�e- �Jmei FraSSU • Com.letian o the ollowin_ table • be waived• the Ins,ector o Wires. No.of Recessed Luminaires No.of Cet1.-S o.of usp.(Paddle)Fans Total No.of Luminaire Outlets Transf°nners KVA No.If Hot Tubs Generators KVA No.of Luminaires 5wimmiag Pool Above In- `o.o mergency • , . ,g No.of Receptacle Outlets • 'd- ❑ `rod- ❑ Bane • Units _ No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection and • No.of Ranges • Initiatin_ Devices No.of Air Cond. ° Tons No.of Alerting Devices No.of Waste Disposers eat Pump umber Tons ME o.of elf ontai, Totals: Detection/Alertin_ Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal J No.of Dryers Connection Heating Appliances , Security Systems:* No.of ater No.of Devices or E.uivalent Heaters KW No.o o.of Si• s Ballasts Data Wiring: No.Hydromass age Bathtubs No.of Devices or E.uivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or 'uivalent Estimated Value of Electrical Wor 8-60 (When additional detail if desired or as required by the Inspector of Wires. Work to Start: � � l (When required by municipal policy.) 5SURANCE CO ns to be requested in accordance with MEC Rule 10,and upon completion. RA E: Unless waived by the owner,no permit for the performance of electrical work mayissue V! the licensee provides proof of liability insurance including"completed operation"coverage or its substantial e undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuingoffice. unless equivalent. The CHECK ONE: INSURANCE BOND ❑ OTHER � I certify, under the pains an a aloes v ❑ (Specify:) FIRM NAME: p fp..--(e O''t1taLlfte informatYon on this application is true and complete c e �.. � t e -Itr-t,,ca„,t _ Licensee: o LIC.NO.: L (If applicable,enter"exempt” Signature�`11PIO /ri/ Address 1Z t"in th license number line.) / LIC.NO.: 11 Ski'' . .l -- ' 02-5 / Bus.Tel.No. 22. 3 08 j "Per M.G.L. c. 147,s.57-61,security work requires OWNER'S INSURANCE WA eP ent of Public Safe Alt.Tel No.: .:; _ , WAIVER: I am aware that the Licensee does not have the liability insurse: ance coverage nc. No. — o—�- required by law. By my signature below,I hereby waive this requirement i am the(check one o t Owner/Agental ❑ � Signature 0 owner's a:ent. - Telephone No. PERMIT FEE: $ Ts---