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Home My WebLink AboutBlde-20-001084 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001084 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:8/27/2019 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) 16 GARDINER LN Owner or Tenant MCDERMOTT ROBERT B SR TRS Telephone No. Owner's Address MCDERMOTT MARGARET M TRS,46 VILLAGE RD, PAXTON, MA 01612 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: Septic pump&alarm. 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 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 1 Totals: Detection/Alertinc 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 ,Sicns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs ,No.of Motors 1 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: DAVID W SILVA Licensee: David W Silva Signature LIC.NO.: 20608 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 THISTLE DR,CENTERVILLE MA 026322036 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: $50.00 aet 1(I (I l.ommonweatth o`Masaaeliuseth Official Use Only , ' Ail' '� • Apartment cc77 Permit No. t S Lkt ail 1Jepartment o`Jirs�arvice.4 { '' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ' � [Rev. 1/07] (leave blank) CY 1 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR 2.00 " „(FLEA$E.F,RINTIN INK OR TYPE ALL IIVFOPMATIOIV) Date: 8� ' d�j9 € r '- ,city or Town of: y ,/lip of•/9 To the Inspector of ires: LL9 l Bthis! p_cation the undersiged gives notice of his or her intention to perform the electrical work described below. �� P I1oaati4C( {treet&Number)�/j �Bf �jr f Z� Se' �/'A//M�gig ' p /� �C/ c� ff Telephone No. / 904/$ 9 F i enant /7O16i'i/f /E e 0 Omaert'iOdress ,52,2 fib ! Lu s Is is p ri4it in conjunction with a building permit? Yes ❑ No 14, (Check Appropriate Box) 1 --- urrpesiamof Building Utility Authorization No. `' ----Ezlct1ng'S'rvice Amps / Volts Overhead❑ Undgrd gr ❑ 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: /;,/f�. s v 6 .�te.14/4r,t1 ,7 f s.74"j, Z Completion of the following table may be waived by the Inspector of Wires. j NroNo.of Recessed Luminaires No.of.CeiL�nsp.(Paddle)Fans of Total Transformers KVA Ili , No.of Luminaire Outlets No.of Hot Tubs Generators KVA VA Above In- No.of Emergency Lighting j! No.of Luminaires Swimming Pool grnd. ❑ grnd. 0 Battery Units _ ,� No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones V No.of Detection and r No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Toil No.of Alerting Tons Devices f 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 Municipectional 0 Other Conn HeatingAppliances Security ytems:* 1 No.of Dryers pp ICGV No.of Devices or Equivalent No.of Water KW No.of No.of -Data Wiring: N. Heaters Signs Ballasts No.of Devices or Equivalent Vr) No.Hydromassage Bathtabs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent \�) OTHER: • • Attach additional detail if desire4 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 ❑ BOND 0 OTHER 0 (Specify:) • I certify,under the sins and penalties ofperjury,that the information on this application is true and complete. FIRM NAME:"e e' '/e"..�, c/1 CA/p.P/ J2 ' LIC.NO. Of USA . • Licensee:62y�,'V,i7 C/�,/ Signatuf y,1 4,4, LIC.NO.y9n p (If applicable,enter "exempt"in the license number Bus.Tel.L No. Address: t- `'K d`.C.4974 /.+1Sfil'fr iefe/i/i2!''A C//js�A, • Alt TeL No.:5OF.7.r eV/6 . *Per M.G.L.c. 147,s.57-61,security work requires 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 normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone No. I PERMIT FEE: $ 6-0—