The URL can be used to link to this page

Home My WebLink AboutBlde-18-006963 p, Commonwealth of Official Use Only lit_ Massachusetts Permit No. BLDE-18-006963 7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:6/7/2018 City or Town of: YARMOUTH To the Inspector of Wires:cjry(� / Q � 302q By this application the undersigned gives notice of his or her intention to perform the a of/work described below. /� `/JvU�/�t ,G/ �J 7 Location(Street&Number) 21 BAKERS PATH �it... � 7 iZt (�3J/ Owner or Tenant MCGRATH THOMAS F JR 'Telephone No. Owner's Address MCGRATH JOHANNA B,21 BAKERS PATH,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appp6Zfs'ate Box) Purpose of Building Utility Authorization No. �j Existing Service Amps Volts Overhead 0 Undgrd Elo.of Cj New Service Amps Volts Overhead 0 Undgrd 0 Number of Feeders and Ampacity . Location and Nature of Proposed Electrical Work: Remodel basement i O Completion of the following table may be wan .• y ,.1 or of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of : Transformersii No.of Luminaire Outlets No.of Hot Tubs Generators No.of Luminaires Swimming Pool Above ❑ In- CINo.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: 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 i / //r?/ is - 0. 15(74 l'(9 __- Commonwealth,of Madsac ff3 Official Use Only �i== c� Permit No. �+� = llsparfinent o/Jir.&rvice5 -=!=j= r ' Occupancy and Fee Checked 7S db ;;.�' 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 I (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 -- -7, I tip, City or Town of: YARMOUTH To the Inspector of Wires: _ By this application the undersigned gives n 'ee of his or her intentio to rform the electrical work described below. _,-,_m , G Location(Street&Nu � 0 r ", r„ u V I.; if Owner or Tenant , e' (,� Tele hbne No, c y rN. �� p ?fib Z Owner's Address �'',' + Is this permit in conjunction with abuilding permit? Yes ❑ No � -:_ - El (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service ✓ Amps / --)Volts Overhead ❑, Undgrd El No.of Meters . .. ._. New Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters __ __._o_.._. -__ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ,�'/7/ i(� �14 5 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- 0 No.of Emergency Lighting grnd. griid. Batt-_ pi- Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and = Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices 8 No.of Waste Disposers Heat Pump I Number-.f Tons. I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local El Mp Connecunicitialn o ❑ � No.of Dryers Heating Appliances KWSecurity Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KW Signs Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs OTHER: No.of Motors Total HP Telecommunications Wiring: ( - ��J� No.of Devices or Equivalent ` I Attach additional detail ff desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Ins ons 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 a 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 ❑ OTHER ❑ (Specify:) N I cern;Jy, under the pains andpenalties o � ��) jperjury,that the information on this application is true and complete. FIRM NAME: Licensee: Signature LIC.NO.: LIC.NO.: I \' (If applicable,enter "exempt"in the license number line.) Address: Bus.Tel.No.: Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.TeLicl.No No..„ze— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n�— S required by law. y signature below,I hereby waive this requirement. I am the(check one ❑ 7 Owner/Agental owner El owner's a.ent Signature M (4_.) Telephone No y CAS= 0 PERMIT FEE: $