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Home My WebLink AboutBlde-19-007022 Commonwealth of Official Use Only Ems, Massachusetts Permit No. BLDE-19-007022 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:6/12/2019 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 electrical work described below. Location(Street&Number) 7 SPINNING BROOK RD Owner or Tenant BEHNKE DIANA M Telephone No. Owner's Address 7 SPINNING BROOK RD, SOUTH YARMOUTH, MA 02664-4032 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 ❑ 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: Air cond.system 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 rnd. grad. Battery Units No.of Receptacle Outlets 1 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. 1 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 0 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 aeLjt a/24 9 „ .� ‘,. ...) I v 1 Commonwealth cl//lasdac fts • �/ccO� ficial Use Only „....0� �' I• ,t Permit No. �--(9 o 2� �2 =if = ..UaP arfnunt° Serviced t irc -_ = ' Occupancy and Fee Checked ��) d _1�'Y->� ,,_.'' BOARD OF ARE PREVENTION REGULATIONS [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 CMR 12.00 _ _ \-:;-. (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: YARMOUTH To the Inspector of Wires: =� J By this application the rrrndersigned gives notice of his or er intenti n to pe orm the electri work described below. ,_ Location(Street&Number) 7 t v)h reo Owner or Tenant / t-ei�[ Rip e v Telephone No. ` 1 _ y144 a�y7 Owner's Address ,s'�{ilJ ' "Is this permit in conjunction with a buildingpermit? ... Yes ❑ No -C�(Check Appropriate Box) Purpose of Building e S , Utility Authorization No. Existing Service ` Amps /c2D /...9i/ Volts Overhead [ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd grd ❑ No.of Meters Number of Feeders and Ampacity Q Q Lo tionn and Nature of Proposed Electrical Work: it ti ea, 4( ce,.. w2` '1 b /'L x I'i / P Cie-l CZ'0 C' !�1 1/ 6-/C� U el" -/ �r �= Completion of the following table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of Cei1-Susp.(Paddle)Fans No.of Total Tratsformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pool Above ❑ In- 'No.of 1r mergency Lighting und. crud. Battery Units No.of Receptacle Outlets No.of On Burners FIRE ALARMS JNo.of Zones cJ No.of Switches No.of Gas Burners No.of Detection and J Initiating Devices No.of Ranges No.of Air Coati. 1 Total . Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons l KW No,of Self-Contained ` Totals: Detection/Alerting Devices kr No.of Dishwashers Space/Area Heating KW L, ❑ Municipal Connection 0 Other No.of Dryers Heating Appliances , Security Systems:* CZ Cli- No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring Sighs Ballasts No.of Devices or Equivalent Ni No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: . No,of Devices or Equivalent t, OTHER: r'` Attach additional detail if desired or as required by the Inspector of Wires. V Estimated Value of lec ;la!Work: ,k-oo (When required by municipal policy.) Work to Start: rp /p iP P cY) Inspections to be requested in accordance with MEC Rule 10,and upon completion. N INSURANCE C VE GE: Unless waived by the owner,no permit for the performance of electrical work may issue the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Thess 1 undersigned certifies that such cove3ge is in force,and has exhibited proof of same to the permit issuing office. ' CHECK ONE: INSURANCE k BOND f certify, under the sins e • f e❑ OTHER 0 (Specify:) P rlury that the information on this application is true and complete, FIRM NAME: ee, 4-tFt— LIC.NO.: ., Licensee: Signature (If applicable,enter "exempt"in the license number line.) LIC.NO.: Address: Bus.Tel.No.: work requiresAlt.TeL No.: J *Per M.G.L. c. 147,s.57-61,security 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)❑owner ❑owner's agent Owner/Agent I Signature Telephone No. [PERMIT FEE: $