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Home My WebLink AboutE-20-1281 co- Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001281 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:9/9/2019 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) 56 HASTING AVE Owner or Tenant CONNOR KERRY JAY Telephone No. Owner's Address CONNOR MARTHA A, 17 FOX HILL DR,WESTFIELD, MA 01085 . r i Is this permit in conjunction with a building permit? Yes 0 No 0 (Check • '! '. ' Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 '` ' o 'eters _. New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: R&R meter socket for siding. 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 ❑ 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 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 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 r I- ' l.,omenonamald of 2Va�sachwstts • Offici al Use Only go 2eparfnund of ire Serviced Permit No. '— a� l go 6- V.-- ",..t T 1--±:_:' 1 a-- -- ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked •�•` (Rev. 1/07] (leave blank) APPLICATION FOR°PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code , 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: , ‘ 9 0 1_ City or Town of: YARMOUTH To the Inspector of Wires: 033,this application the pndersigned gives no - e of his or her intention to perform the electrical work described below. LLI I ars I tion (Street&Number) ,j y1�.7,i..✓CS ,44- _ 1 N er or Tenant .,�}, ,�/r 4�� ?? � � ��../4/G�C.. Telephone No.�//j-,sJy'.—`Jij/O 11.1 1 ) er's Address ,J9, 4-i,e c.)I Cr) i qs permit in conjunction with a building permit? Yes gj No 0 (Check Appropriate Box) 13)111, ose of Building Utility Authorization No. c 3 S 7 E - rig Service Amps / F Volts Overhead ❑. Undgrd® No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: /S'fisladC d,x 4 zeal-.��few .7;2 ,,e'li Acp S'i.,0"- .e<i,••.yo ,7 ,W2) -Tf.(A•'. 7r�c Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmia Pooi Above In- No.of Emergency Lighting - g grad ❑ ernd. 0 Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Detection and J No.of Gas Burners Initiating_Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number !Tons I KW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ °ther No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of . Heaters ' Data Wiring: Signs Ballasts No.of Devices or Equivalent c/) No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: clj Attach additional derail if desired or as required by the Inspector of Wires. ) Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: . Inspections to be requested in accordance with MEC Rule 10,and upon completion. , INSURANCE C RAGE: 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. i CHECK ONE: INSURANCE ❑ 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: cV LIC.NO.: (41 Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line) ---�— Address: •Bus.Tel.No.: j *Per M.G.L. c. 147,s.57-61,securi work rc Alt.TeL No.: ry quires Department of Public Safety"S"License: Lic.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n S required by law. B y signature w,I hereby waive this requirement I am the(check one)❑owner 0 owner's agent Owner/Agent I Signature Telephone No. /.ir,2./f.1/7/tj I PERMIT FEE: $ ._.)