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Home My WebLink AboutBlde-19-005950 i a 1 p Commonwealth of Official Use Only kE t Permit No. BLDE-19-005950 _ 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 IN INK OR TYPE ALL INFORMATION) Date:4/22/2019 City or Town of: YARMOUTH To the Inspector of Wires: �J By this application the undersigned gives notice of has or her intention to pertorm electrical work desc 'bed bCl plgw. m �trt. Gry l 3 Z�6 Location(Street&Number) 56 CAPT STANLEY RD J/ CJ, Owner or Tenant BURKE BRENDA C(LIFE EST) Telephone No. Owner's Address 56 CAPT STANLEY RD,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 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install switch for portable generator. 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 1 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 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: 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 gkIt41. %71.,D et0 7/6(( s :/ 4/ t • • v _* _ Commonwealth wealth of�a3sachucsatti Official Use Only V '�= _•t :rt__ = apartment f 5-ire Permit No. o cervices BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked St ,..-- ` [Rev. 1/07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ?J a (90 1 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. __,,,,a,.„,......-._. _.Location(Street&Number) <<j'--C (al tai y� fii i L c- L "~�z �Dwner or Tenant �p 1"'" yc .� nd�a k !% 2� Telephone No �f'08 69 - 7as8 + caner s Address � Ain c /Y XI y ' =, Q j s this permit in conjunction h a building permit? Yes ❑ No �` ,a 1 urpose of Building 51 (Check Appropriate Box) iLu' ;w i ��' 'c,,,, Utility Authorization No. cc 1 xisting Service Amps / Volts Overhead (S' Undgrd LI I "C '° ewi Service Amps / y ' ❑ No.of Meters F Volts Overhead❑ Undgrd ❑ No. of Meters 1 Number of Feeders and Ampacity • -~--------"--Location and Nature of Proposed Electrical Work: Cee,s x a, S L4it1i. 4�A F A./ Completion of the follcnving.table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-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 tvmergency Lighting :rrnd. :rnd. ❑ Battery Units No. of Receptacle Outlets No.of Ott Burners FIRE ALARMS INo.of Zones 1No.of Detection and No.of Switches No.of Gas Burners J Initiating Devices Total - No.of Ranges No.of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number Tons H 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 Water No.of Devices or Equivalent 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 of Electrical Work: (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 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 o ) fper perjury,that the information on this application is true and complete. FIRM NAME: Gz &rr "p VA I f ey t, Licensee: �) LIC.NO.: Signaturekoy p 1� }0 LIC.NO.: (If applicable,enter"exempt"in the,license jT Go 1 �1 line.) Bus.Tel.No.: . Address: ' �6 CAF A)v\ 3TioNlei ' �1 .vai —fl NA J *Per M.G.L. c. 147,s.57-61,security work requires Department of Pub SafetyAlt.Tel.No.c. : OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage n— orma — 5 required by law. By my signature below I hereby waive this requirement. I am the(check one ❑owner ❑owner's a ent. Owner/Agent I Signature t 14\ Telephone Nck6/1�75`3 PERMIT FEE: $