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Home My WebLink AboutBLDE-19-005889 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005889 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:4/18/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform th ctrical work descri e below. Location(Street&Number) 42 PEBBLE BEACH WAY lLb V Owner or Tenant . .....115=14 41.11l��ire— Telephone No. Owner's Address t* __._.._ ...__.__A A,42 PEBBLE BEACH WAY, SOUTH YARMOUTH, MA 02664 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: Renovate kitchen. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 8 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 3 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 No.of Gas Burners No.of Detection and Initiatine 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 1 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:) 1 certify,under the pains and penalties of perjug,that the information on this application is true and complete. FIRM NAME: WILLIAM M MASSEY Licensee: William M Massey Signature LIC.NO.: 28400 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:26 DWIGHT ST,WORCESTER MA 016032385 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 P-Wde--T"(M2 Spoots NAVE-Lip) S frsit e--4MPct s/1 "ft&4 ci(3 � 9 (5 �o �y�j ' �._' _, mmonwealg; j; > ltd -S__i cc��tAczrfmant`oPermit Noviced �Y_.��,�.- BOARD OF FIRE PREVENTION REGULATIONSOc anry and Fee Checked � I •ev. 1/07] eave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL All work to be performed in accordance with the Massachusetts EIectrical Code WORK (PLEASE PRINT'IN INK OR TYPE ALL INFORMATION) 527 CMR I z.00 City or Town of: �T D RTMTATTION . �l— �'_ By this application the pn of: ed ve R 1 E ) To the Inspector of Wires: otic o hi or her in .tion to perform the eIectricai work described below. • Location(Street&Number) �/b� e�e4 Owner or Tenant • _ _, _ Telephone No Owner's Address 0, 04 i , /1 ® � Z Is this permit in conjunction with a building permit? Yes M No ... CT) ! rpose of Building 0 (Check Appropriate Box) Utility Authorization No. L1A>1 co sting Service (] Amps 0/ 32Volts Overhead ❑ Uadgrd,�/ N w Service Amps / b L No.of Meters ---__Volts Overhead❑ Undgrd "a / `� 3N' inber of Feeders and Ampacity -ht ❑ No,of Meters _ oL' ation and Nature of Proposed Electrical Work: p , awn �. t t fit. �� '1 s CD i Co 'felon o the ollowin- table m. be waived. the Ins.ector o Wires. No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans o.of Total d() No. of Luminaire Outlets No. Transformers ICVA of Hot Tubs Generators No.of Luminaires KVA Swimming Pool Above In- •p• mergency Ung No.of Receptacle Outlets `ted' El °md' D Ba • Units ea No.of Oil Burners No.of Switches No.of Zones No.of Gas Burners o.of Detection and No.of Ranges Initiating Devices No. of Air Cond. No.of Alerting Devices No.of Waste Disposers Heat PumpTons umber Tons o.of elf-Contain, Totals; ' Dot. No.of Dishwashers / Space/Area Heating KW Local❑ MuaicipaDevices No.of Dryers Connection ❑ Other Heating Appliances , Security Systems:* No. of ater No.of Devices or E.uivalent Heaters KW No,o o. of F Si s Ballasts Data Wiring: No. Hydromassage Bathtubs No.of Devices or E.uivalent No. • of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent Estimated Value of Electrical Work Cf v ` desire f Attach additional detail i d or as required by the Inspector of Wires. Work to Start; (When required by municipal policy.) Work S Inspections to be requested in accordance with MEC Rule 10,and upon completion, CE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work mayissue 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 i unless CHECK ONE: INSURANCE equivalent. The BOND ❑ OTHER P Issuing office. I certify, under the .•ins'6and penalties . �•tt ❑ (Specify:) FIRM NAME: ` I fp��'�that the information on this application is true and complete. Nta [IC.NO. 2 Licensee: (Ifapplica,e, to ' -mpt'•in the licerue Signature , Address: r in _ LIC.NO.: / Bus.Tel.No.: J Per M.G.L. c. 47 s.5 �.1,securityw.. s//A fJ , Q OWNER'S INSURANCE WAIVE : I squires Department of Public SafetyAlt.Tel.No.: S OWNER'S ' law. my "S"License:iabilLin. No. ware that the Licensee does not have the liability insurance coverage n� 5 Owner/Agent by la By signature below,I hereby waive this requirement I am the(check one 0 Signatureg nnaily lI owner ❑owner's a.ent Telephone No. PERMIT FEE: $