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Home My WebLink AboutBlde-20-000612 Commonwealth of Official Use Only ✓ �'� Massachusetts Permit No. BLDE-20-000612 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:8/2/2019 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 ork described below. Location(Street&Number) 67 BERRY AVE 17—qvg— 415 227 Owner or Tenant PRENDEVILLE LAWRENCE J Telephone No. Owner's Address PRENDEVILLE CAROL E, 93 SUMMIT AVE, QUINCY, MA 02170 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: Repairs to service due to tornado damage. 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 0 In- CINo.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 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 ❑ 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: Francis X White Licensee: Francis X White Signature LIC.NO.: 14675 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:500 VICTORY ROAD,QUINCY MA 021713139 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 OIL b. ePtC1 iA me_ ( q2. 8 Li 5S C 25c(.92 (6,44_42 cam) e\ QT7 r..i1 f 9) ii -5 $/2/l 9 ! - Commonwealth of Mas.6achCa3alt1 • Official Use •.1 '• �� / .(JaParlm¢nE o{emirs Permit No. �`-' �� P �'' -11;— _. Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 5e OD [Rev. 1/O7 (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance yrith the Massachusetts Electrical Code(ME , 27 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: C// iti City or Town of: YARMOUTH To the Inspector o Wires: (] z y this application the rcindersigned gives notice of his or her intention to perform the electrical work described below. W ocation (Street&Number) 67 cr er or Tenant L A A A ,4 1 r,t. L .- wner's Address Telephone No. 2- 1 W $� 4 D this permit in conjunction with a building permit? Yes ❑ No V cp zEl (Check Appropriate Box) W ,Q o urpose of Building Utility Authorization No. m,. xisting Service 3-CO Amps f / �`/OVoits Overhead ' Undgrd El No.of Meters ew Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Mete Number of Feeders and Ampacity L'th,ay/y L./ Kr0 ..� A . J4:jlI ''---) Location and Nature of Proposed Electrical Work: < -- 1 Completion of the following table may be waived by the Inspector of moues. No.of Recessed Luminaires No.of Cei1.-Busy.(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 Lmergency Lighting erred. erred. Battery Units No.of Receptacle Outlets No.of Ott Burners FIRE ALARMS 1No.of Zones - No.of Switches No.of Gas Burners No.of Detection and Iaitiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals:I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ MunIcipai - Connection ❑ °ther 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 Teiecommanications 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: `0 DO "•.._ (When required by municipal policy.) Work to Start: / f 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 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: tc�X Ikx4l2tcq/ LIC.NO.: J` �i Licensee: -4 (4t-(.( Lk)1 1/ u Signature. "-- (If applicable,enter"es pt"in the license nu ben line) .-`� l LIC.NO.: Address. (bfa 0 v) (46 I o ,?O t/�t^ 4 ( 1 �, Bus.Alt Tel.No.: �Tja�� / J `Per M.G.L. c. 147,s.57-61,security work requires Department/ /of Public Safety LicTel.No. • .No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have liabili• insurance coverage�— � required bylaw. Bymysignaturen' normally below,I hereby waive this requirement I am the(checkone)❑owner ❑owner's agent Owner/Agent I Signature Telephone No. [PERMIT FEE: $ j