The URL can be used to link to this page

Home My WebLink AboutBlde-20-001212 ("& Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-001212 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:9/4/2019 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) 105 WIANNO RD Owner or Tenant MANOS DIANE M Telephone No. / Owner's Address 105 WIANNO RD,YARMOUTH PORT, MA 02675 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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wiring for screen porch. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 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: TYLER W PAYNE Licensee: Tyler W Payne Signature LIC.NO.: 22091 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 JANS PATH, HARWICH MA 026452458 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 U-ae q(5-1( q cfv'1°� q/Z3/ 7 t A Commonwealth of Massachusetts r Official Use Only jnly s� �� / Permit No. `�k ��- Department of Fire Services !- Occupancy and Fee Checked 1 -- BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/O51 (leave blank) 6APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),52 C R 12.00 6 (PLEASE PRINT IN INK OR TYPE ALL INF RMAT ON) Date: q I-� l City or Town of: Y � To the Inspector of ires: r,,.. .- - "1By this application the undersigned give notice,of his or her intention to pe •im the electrical work described below. t: _..�_.. --1 Location(Street&Number) 0 is / o," j 111Owner or Tenant • fl Mania Telephone No. 11 . 1 Z_ Z 1r rnU)tannfl 1�';% ('� wner's Address /05 E` ,y �1 b [ 9 Is this permit in conjunction with a building permit? Yes ❑ No El (Check Appropriate Box) r; . —i urpose of Building Utility Authorization No. 1 ? 1 ) xisting Service Amps / Volts Overhead n Undgrd❑ No.of Meters Le' ril _New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters ,11 -� �`�___umber of Feeders and Ampacity p 1,� /� Location and Nature of Proposed Electrical Work: (A) I red 3 1e ene i in pOf` ,' 1 Completion of the following table may he waived by the Inspector of Wires. NoNo.of Recessed Luminaires No.of Ceil.-Susp. Tr KVA Transformers KVA(Paddle)Fans of No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No.of Emergency Lighting grnd. ❑ grnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of No.of Switches No.of Gas Burners No.Initiatinnggon Dete and n Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices 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 El Connection Connection ❑ Other 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: 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 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:P# N e £L, cfL,R,t I NEC. LIC.NO.63O7 L.1— , Licensee:-TV L IN J. PkYlue Signature/ /jy1t.+t/., ) �.c.. LIC.NO.:22 VA (If applicabl enter "exempt"in the license number line.) / Bus.Tel.No:M 7�C1.3 11 Address: •1 kIV,'� 1 t--r!-f ttikki\(I( C) 1-,L i Alt.Tel.No.f-T7'4 2.12.. 592, *Security System Contractor License required for this work;if applicab e,enter the license number here: 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. I PERMIT FEE:$ Z5