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Home My WebLink AboutE-19-145 Commonwealth of Official Use Only Var Massachusetts Permit No. BLDE-19-000145 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:7/10/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electncal w k described brsjiyay Location(Street&Number) 29 MACKENZIE RD IEj V-6) I t -2-1v Owner or Tenant Telephone No. Owner's Address lf- AIF_1lfLTlell# Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A' •ropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 i?,,,pl. viav�%/New Service 200 Amps Volts Overhead 0 Undgrd ❑ o. . kie Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence Completion of the following table may be a •`4.,,c or of Wires. No.of Recessed Luminaires 40 No.of Ceil:Susp.(Paddle)Fans No.of Transformers v No.of Luminaire Outlets 12 No.of Hot Tubs Generators ' A No.of Luminaires Swimming Pool Above ❑ In- I: No.of Emergency Lighting grnd. grnd. Battery Units - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 24 No.of Gas Burners 1 No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 Total 2 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 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: John C Tierney Licensee: John C Tiemey Signature LIC.NO.: 33987 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:48 BEAVER ST,WALTHAM MA 024537006 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$230.00 / _j"-?:0--1-- 7/ 1 ull 1 s ,a C.Ommorwisa[th I kA i. ., cc'�� of///assac fft Official Use Only „ w,,, �6 .i ..0 1 L ml sparfinent o f..irs Serviced Permit No. �pp BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked I M •,v [Rev. 1/07] (leave blank) i .,r t pN APPLICATION 'FOR:PERMIT TO PERFORM ELECTRICAL WORK f� - All work to be performed in accordance with the Massachusetts Electrical Code(ME. ,527 CMR 12.00 L , _._._ ..e...(PLEASE PRINT IN INK OR TYPE ALL INFORMATIOII9 Date: 9 /L1�1 City or Town of: YARMOUTH To the Insp ctor 6f Wires: By this application the widersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) ) /"9 M *Icem rd 2i ✓Z Owner or Tenant --3-6^, I f J 17 ‘V‘r Y9S Telephone N 3.�-c Owner's Address 4 S136v e 5 = Ali. ifri? mit O2 it S 3 Is this permit in conjunction with a building permit? Yes Er- No ❑ (Check Appropriate Box) Purpose of Building 1 r=, ,,,j(ii l'1 LI/tWi a Utility Authorization No. Existing Service Amps ----L Volts Overhead ❑. Undgrd El No.of Meters — New Service L Amps / ?' i7 L Volts Overhead[ --'•Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires .9 0No.of Cei1-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets ! No.of Hot Tubs Generators KVA No.of Luminaires /�. Swimming Pool Above r-i In- ❑ No.of h mergency Lighting - �rrnd. srvd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS f No.of Zones No.of Switches c / No.of Gas Burners No.of Detection and _: Initiating Devices No.of Ranges No.of Air Cond. Tod 4� No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I TonsW No.of Self-Contained Totals:I Detection/Alerting Devices No.of Dishwashers ( Space/Area Heatin Municipal g KW' "cal Q Connection ❑ Oth7 No.of Dryers Heating Appliances , Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters KWNo.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 in ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such covera is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties o ) f perjury,�that the infonria&o on this application is true and complete. FIRM NAME: cdttur f T- . ,,t, LIC.NO.:i Licensee: Y , hk 77C3 JI.L Signature C LIC.NO.: 7C (If applicable,enter.,�'�e-x�empt' in the license num er line.) Address:413'OP tx. 4i a m Bus.TeL No.: ��s- J "Per M.G.L.c. 147,s.57-61,security work requires Departme of Public Safety"S"License: Alt.L c!.No., vzt - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityinsu . rage�'— S required by law By my signature be?t3�*, by waive this requirement I am the(check one /'ti, ownerco❑owner's a11eynt Owner/Agent C ..r ' 1.11 Signature r Telephone No. PERMIT FEE: $ i