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Home My WebLink AboutBlde-19-000816 T 1 W A\ Commonwealth of Official Use Only BLDE-19-000816 'Alkali No.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:8/10/2018 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 electncal work described below. Location(Street&Number) 46 RAINBOW RD Owner or Tenant DIBELLA ROSE C Telephone No. Owner's Address 29 MORN INGSIDE DR,ARLINGTON,MA 02174 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 N Meters New Service Amps Volts Overhead 0 Undgrd 0 r r Number of Feeders and Ampacity a�/� s , Location and Nature of Proposed Electrical Work: Rewire residence. �[ O Completion of the following tab e L/ — t e 44e• s e PVtofires. No.of O rt No.of Recessed Luminaires 14 No.of Ceil:Susp.(Paddle)Fans Transformers � Ek ns ormers No.of Luminaire Outlets 6 No.of Hot Tubs Generators 4) No.of Luminaires Swimming Pool Ab ❑ In- I: No.of Emergency Lighting grnove d. grnd. Battery Units No.of Receptacle Outlets 20 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 ty`► Tons No.of Waste Disposers 1 Heat Pump Number Tons KW No.of Self-Contained 3 Totals: Detection/Alerting Devices No.of Dishwashers 1 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 1 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 ei/, a(65 e . "" 6,.)„4_,__ P 4W&,4IL-i-Gli t t=r& aza j 91120f e mmOnwa of 2 aaaachu i Official Use Only cc77i Permit No. mit `- eparfinant el}rs Servicla t 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 CodellvffiC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO11) Date: d'/7/l City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or1 _�s� her intention to perform the electrical work described below. Location(Street&Number) 7qe /(,2/tifY(A. Owner or Tenant Aire '�cl 1 Telephone No. /j 5737 Z�Y y Owner's Address I / 4,664) i2) Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (Ot'^/2/e-X AF W/ t? Q.. .'.. Completion of the following table may be waived by the Inspector of Wires. v No.of Recessed Luminaires / No.of Ces1.-Sasp.(Paddle)Fans No.of Transformers O KVA 6 No.of Luminaire Outlets G No.of Hot Tubs d Generators 0 KVA • No.of Luminaires 0 Swimming pool Above ❑ In- ❑ No.of l!mergency Lighting grad. grnd. Battery Units C) No.of Receptacle Outlets 'Z!) No.of Oil Burners O FIRE ALARMS INo.of Zones No.of Switches 0 No.of Gas Burners o No.of Detection and ` Initiating Devices No.of Ranges No.of Air Cond. C.) To •ms No.of Alerting Devices No.of Waste Disposers r HeatTotals: Pump I Number I Tons I KW No.of Self-Contained 0 Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local Municipal E Connection ❑ Other No.of Dryers 0 Heating Appliances 0 KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters No.of No.of KW (� Data Wiring: Signs 6 Ballasts No.of Devices or Equivalent C7 No.Hydromassage Bathtubs No.of Motors 0 Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 'll Attach additional derail if desired or as required by the Inspector of Wires. Estimated Value A H/of Electrical Work: 7 Z v.) (When required by municipal policy.) Work to Start:!"/n 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:) 1 cert}fy, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.: Address: j "Per M.G.L. c. 147,s.57-61,securitywork requires Department of Public SafetyAlt.Tel.No.: q ep "S"License: Lic.No. —vt OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S Owner/Agent by law. B my signature below,I hereby waive this requirement.�f I amr the(check one)0 owner 0 owner's agent. Signature al - ,` Telephone No. l/��J 1,-2� PERMIT FEE: $ / 775i-L e66( L /c c,3) -.71-&-litV