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Home My WebLink Aboutblde-18-006345 V — Commonwealth of Official Use Only /Ark° Massachusetts Permit No. BLDE-18-006345 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:5/14/2018 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 electrical work described below. Location(Street&Number) 127 RIVER ST Owner or Tenant CHURCHILL W H JR TRS Telephone No. Owner's Address BASS RIVER TRUST/C/O DIANA CHURCHILL,243 PLEASANT ST,SOUTH YARMOUTH, MA 02664 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 etrs Number of Feeders and Ampacity O Location and Nature of Proposed Electrical Work: Septic pump&alarm. I 111 p Completion of the followi ,' r f• .aiv ,ty. ctor of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No. Total Tian11? i er O KVA No.of Luminaire Outlets No.of Hot Tubs Genera i KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.o ighting grnd. grnd. 'Batte lop 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 1 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 Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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 W SPRINGER Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 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:$50.00 K/' 01( ( l • r7 l _ Commonwealth of///adduce Official Use Only �' =t `� Permit No. /fc>= 5 eparfinant ol..tirr Serviced t ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07) • (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ,j/ i /i City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the pndersigned gives notice of his or her intention to perform the lectrical work described below. Location (Street&Number) 1 2_1 C C PCA 6 5 av t-k,1 U r10 LAI Owner or Tenant F rfc' C V‘j.CAA ( Telephone No. Owner's Address '_. Is this permit in conjunction with a building permit? Yes ❑ No E (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑. Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Q Number of Feeders and Ampacity Iodation and Nature of Proposed Electrical Work: N e S c$ t;- c`c.f uA o.v e v M u Completion of the following table may be waived the R by Inspector of Wires. c� Iq of Recessed Luminaires No.of Cei7.-Snsp.(Paddle)Fans No.of Total 9 w ' c 11 of Luminaire Outlets No.of Hot Tubs Genera Transformers KVq s Generators KVA % 10 of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lbghtmg '� # grnd. grad. Battery Units 3 IA f !No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS [No.of Zones Iif.lOf Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Ton No.of Alerting Devices 1 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 HeatingMunicipal KW L Q Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KWData Wiring: No.of 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: Z 000 (When required by municipal policy.) Work to Start: S J I l / 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 covera in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify:) I certtfy, under the airs and penalties of perjury,that the information on this application is true and complete. FIRM NAME: c-CV.( �Iectci L LIC.NO.: Z(1 (2 r/i Licensee: JC__i) ('',t\ Signature &iFF--. I applicable,enter"exem t"in ties lice^Fe� num er line.) LIC.NO.: Z �j (f aPP ' Bus.Tel.No.: 57�p 3C=y d 131 r J. Address. 1O iS\NifS - C: \ ni Alt.Tel.No.: "Per M.G.L.c. 147,s.57-61,security work re ires 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. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's a ent. Owner/Agent I Signature Telephone No. ( PERMIT FEE: $ ,j .�..