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Home My WebLink AboutBlde-19-004778 ....„... .„. C___ Commonwealth of Official Use Only Permit No. BLDE-19-004778 .4: $7 Massachusetts - 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:2/24/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives nonce of his or her intention to perform the electrical work described below. Location(Street&Number) 6 SACHEM PATH Owner or Tenant JOHNSON KALLIN Telephone No. c Owner's Address JOHNSON LINDA,26 GERMAIN ST,WORCESTER, MA 01600 0 I ip Is this permit in conjunction with a building permit? Yes 0 No 0 (Ca Purpose of Building Utility Authorization N `m a, '�' c a r Existing Service Amps Volts Overhead 0 Undgrd 0 `o.o eters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence. Completion of the.follovving 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- ElNo.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 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 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 perjuiy,that the information on this application is true and complete. FIRM NAME: Russell J Davey Licensee: Russell J Davey Signature LIC.NO.: 16823 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 12 CEDAR OAKS DR, PLYMOUTH MA 023607804 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: $180.00 'e-)c.)raati 1 tzOlt ct ge-- ---- t(Nlac (No Apt V- It 'i ((c 7/1(y e FC-- 4: 1)6,g—i ( 744? ll 4 , J , , `/'� Mj / — _. __ Commonwealth ot///a�actu�sfts • Official(Use Only =sil- 2cpartmani i.7ir.Serviced Petmit No.C--�l� l l o z >- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked W rRev. I/07) (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK N �. All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 LU c\l , (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO!9 Date: —22 —/7 V`' City or Town of: YARMOUTH To the Inspector of Wires: By this application the t,mdersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) ‘ S'y G`i ems, p 9 Th ye,v ill Uc _0,2 6 73 ...—_.__ _a.._.I Owner or Tenant /fs7 e/q 3-0' ,7 SG17 Telephone No. Owner's Address .2 4' g e rir7 Qfr7 SY' 1,,,eirG r Per✓ 141 9 t 2/ G 2— Is this permit in conjunction with a building permit? Yes 2 No ❑ (Check Appropriate Buz) Purpose of Building /7r S'e/eht p Utility Authorization No. .2 ?,2 (� 3 3 7 Existing Service Amps / Volts Overhead ❑ Undgrd gr ❑ No.of Meters New Service It Amps ) / 2ke2Volts Overhead,® Undgrd ❑ No.of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: N.0 tom. e /ic-7%-c / Styes/Ley 1.//G ec /H p/t'7C '& S L 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 Swimnua pool Above In- No.of Emergency Lighting g erred. ❑ 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 Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons H KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Municipal Local❑ Connection El other ` No.of Dryers Heating Appliances , Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW No.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 01, 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:2,--/ k--/7 Inspections to be requested in accordance with MEC Rule 10,and upon completion. lit 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 25- BOND ❑ OTHER ❑ (Specify:) I certzfy, under the_Rains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ii'l U 7 e/rG7' c- Q LIC.NO.: /� �,Z Licensee: /U S 5e Gf J Pi 1,,y rip. Signature / (If applicableenter "exempt in the license numb line.) LIC.NO.: �: Address GY GY Q q`S I/ �� tyl Gi/ j s.Tel.No.: j Per M.G.L. c. 147,s.57-61,security work requires d Alt.Tel.No.: - �,�?�epartrnent of Public Safety"S"License: Lic.No. ,,,,z— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverarnany ge n— o — S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner ['owner's a ent_ Owner/Agent al Signature Telephone No. PERMIT FEE: $