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Home My WebLink AboutBlde-19-004931 Commonwealth of Official use only of -�• t Massachusetts Permit No. BLDE-19-004931 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:2/28/2019 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) 77 OLD HYANNIS RD Owner or Tenant MITCHELL NICHOLAS G III Telephone No. Owner's Address MITCHELL HEATHER S, P 0 BOX 2120, SOUTH DENNIS, MA 02660 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: Wiring for garage. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 13 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 3 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: David Picard Licensee: David Picard Signature LIC.NO.: 13902 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 19 ELLIOTT RD, CENTERVILLE MA 026323643 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: $75.00 04 71(UL. 67 asp �> Pe • COMMOSIVOS&el Masseeekeeetts Of' IuseOnlyr/� • • ', 24 petrbn.nt /.tier service Permit No. 2] -'"l"1 1 F; Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA77ON) Date: �`\9 City or Town of: ygriMv,l To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 11 O1 kAt fAm.15 �o Owner or Tenant C\k(k. ��1/4( A ` Telephone No. 5O$ a-a.J�$� Owner's Address 'fl O 4oA1\tS Is this permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Box) Purpose of Building rk\—\ A Utility Authorization No. Existing Service ('IZ Amps I a.o/ Q Overlie El Undgrd Ea, No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity Lranon and Nature of Propred Electrical Work: O C..rac o 'Pvt\k d kvsk �koO. ,r,Ax`�6h.e.d t� ate. J _ V l ( Completion of the following.table my be waived by the/n for of Wires. '.Y No.of Recessed Luminaires 1� No.of CeiL�p.(Paddle)Fans No.of KVA ,,, Transformers KVA \, No.of Luminaire Outlets 3 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above mud. ❑ grad. ❑ Battery Uerl easy Lighting ilts No.of Receptacle Outlets k 0 No.of Oil Burners FIRE ALARMS No.of Zones No.of SwitchesNo.of Gas Burners No.of Detection and O c. Inidatantt Devices tal 11 No.of Ranges No.of Air Cond. Ta No.of Alerting Devices ns . —No.of Self-Contained _ �J No..of Waste Disposers Heat>op Number Tons __KW--_- Detection/Alerting Devices �` Ni of Dishwashers Space/Area Heating KW Local❑ Cp H ❑ Other 4 , ' Nt of Dryers Heating Appliances KW N"Secua of Devices or Equivalent r4.oi�Water , No.of No.of Data Wiring: 4iromassage Heaters Signs Ballasts No.of Devices or ' " 1 •- t 1 r c, a Bathtubs No.of Motors Total HP Tele f oxNo.of Devices or Equiv t Lii k S.t... Lt QTHitR: j ": Attach additional detail if desirat or as required by the Inspector of Wires. ._.... -. ..-.._.__Estimated Value El 'cal Work: A ypeo (When required by municipal policy.) Work to Start: \ \ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO E: 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 '2I BOND 0 OTHER 0 (Specify:) I cerAffy,under the pains and penalties of perjury,that information on this application is true and complete. FIRM NAME: )C 'Qv{4 c ,�`o c QA LIC.NO.:N3 -Q Licensee()O Q Q‘cos- Signatur{ L \---- LIC.NO.: (If applicable. ter"exempt"in the license number line Bus.Tel.No.: e(IS ( S' 23Q( Address: 11.�\to kr (Zd ce4ery 1\\Q1 1.AA O 2(43 a. Alt.Tel.No.: *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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$ 7 5 -' r' v