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Home My WebLink Aboutblde-20-000408 a Commonwealth of Official Use Only u' IN Massachusetts Permit No. BLDE-20-000408 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:7/24/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 49 LEWIS RD Owner or Tenant BAGGAN EDWARD R Telephone No. Owner's Address BAGGAN JANE M,49 LEWIS RD,WEST YARMOUTH, MA 02673 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: Repairs to service as needed. 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/Alertine 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: Thomas J Madden Licensee: Thomas J Madden Signature LIC.NO.: 14065 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:39 MARINERS LN,PO BOX 291,YARMOUTHPORT MA 026750291 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:$50.00 /v4c magi'(ZS? Y N•a nfeee.) r `/'� yyy�jj L.- Commonwealth oil///as4ac�lts • Official Use Only _ ..., - - 2eparfineni of.}ire J Permit No. `C (4Q g t' • erviced Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/0 ---- (leave blank) ', APPLICATION FOR°PERMIT TO PERFORM ELECTRICAL WORK Al work to beaccordance with the Massachusetts Electrical Code performed in ),527 12.60 �� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: —2 , 7 City or Town of: YARM To the Inspe OUTH of ti / for Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) �ttJ Owner or Tenant fk J a,, y9 ' �� r �� ' `•��` v" 4,.fy4 ii Telephone No.$Qg.77t a? -b Owner's Address Sgi'vl ,e I ' Is this permit in conjunction with a building permit? Yes // ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Mr Amps J?O /„WO Volts Overhead EL! Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical ork: 4:. fM e V 1_0,�C 5.2 A.z ,4-f)-Q z 4 wt. �.t, firfr. Completion of the follrnving,table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce�1.-Snsp.(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. 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump]Number I Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring 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 if desired or as required by the Inspector of Wires. Estimated Value o lec 'cal WorJOO,�(When required by municipal policy.) Work to Start: 7 da 1 q Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C YE GE: 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 covers in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE LE"BOND ❑ OTHER ❑ (Specify:) I certify, under the penalties f erjury,that the information on this application is true and complete FIRM NAME: ( W` LIC.NO.: �� '- Licensee: Signs (If applicable,enter "exempt"in the license number line.) •NO.: Address Bus.Tel.No.: �� 'tf J Per M.G.L. c. 147,s.57-61,security work requires D Alt.Tel.No.: 7 qu eparrrnent of Public Safety"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 ❑owner 7 Owner/Agent ❑owner's a eat Signature. Telephone No. PERMIT FEE: $ SO- -