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Home My WebLink AboutBlde-20-000455 or Commonwealth of Official Use Only 4\ Massachusetts Permit No. BLDE-20-000455 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:7/26/2019 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) 12 YACHT AVE Owner or Tenant SOARES DAVID(LIFE EST) Telephone No. Owner's Address SOARES IRENE(LIFE EST), 12 YACHT AVE,WEST YARMOUTH, MA 02673 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 ❑ 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: Service repairs. 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 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 perjury,that the information on this application is true and complete. FIRM NAME: David M Smith Licensee: David M Smith Signature LIC.NO.: 31671 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 HOWARD RD, HARWICH MA 026453207 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 pantry nc-0 44 - - = Commonwealth of///addac ffs Official Use Only 1 �_� _/ ep o{Jzrs Services `� Permit No. �-0 gq� BOARD OF FIRE PREVENTION REGULATIONS ev. 1/0/07] (l.Occupancy (l Fee Checked v. eave blank) isfl 14 APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 CMR 12.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: „Tv 1-`1 a b , b j / City or Town of: YARMOUTH To the Inspector of Wires: )- By this application the pndersigned gives notice of his or her intention to perform the electrical work described below. ;,;e/) Location(Street&Number) 4 l Y 4 4 N 7-- i J t Owner or Tenant 14- f 1 P` cJ Telephone No.� s' _ 1 _� Owner's Address --1 y �. YA-c i-1 -r 4 v Is this permit in conjunction with a building permit? Yes ❑ No ,� (Check Appropriate Box) Y Purpose of Building ' L i_ I A) 6- Utility Authorization No. Existing Service 100 Amps ja0 / :ND Volts Overhead LJ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 0 N I_ Completion of the following table may be waived by the Inspector of Woes. No.of Recessed Luminaires No.of Ce�1-Susp.(Paddle)Fans No.of Total Transformers I{VA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmin Pool Above In- No.of?Tr. Lighting _ g grad grad. � Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones - No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.. of Air Cond. TOe No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loral Q Municipal Coection0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Ballasts - Data Wiring Signs 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 i Mm Y t 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 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, ander the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DrIV ( t� LIC.NO.: Licensee: f i,, �M Ilk Signature 4414 ./ applicable, ' , LIC.NO.: (Ij enter"exempt"in the license number line.) Address: 6a G'c12. 1,, N S ►�/( �F (lac ,p Bus.TeL No.: -9'53 j Per M.G.L.c. 147,s.57-61,securitywork requires / Alt.TeL No.: 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 S required by law y below,I hereby waive this requirement. I the(check one)El owner El owner's agent. Owner/Agen am I Signature O Telephone No.5 r�Qg _d r-T [PERMIT FEE: $ hv---- 00.2 y-