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Home My WebLink AboutBlde-19-003852 a Commonwealth of Official Use Only tilith Massachusetts Permit No. BLDE-19-003852 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:1/2/2019 City or Town of: YARMOUTH To the Insp of Wires: By this application the undersigned gives no ice o is or er men ion o pe orm e e ec c k described be w. Location(Street&Number) 87 QUARTERMASTER ROW (b+}-NJ � Owner or Tenant BURKE DONNA M elephone No. Owner's Address BURKE CHRISTOPHER J, 3732 EDINBOROUGH DR, ROCHESTER HILLS, MI 48306 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 i New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement HVAC. 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 grad. grad. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. 1 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 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 ❑ (Specify:) I cernfy,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Joseph W Silva Licensee: Joseph W Silva Signature LIC.NO.: 9147 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 BOURNE HAY RD, SANDWICH MA 025632761 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 / 4- % (3(Y6 ci/Zsg /to( — Commonwealth a�massa� Official Use Only Permit No. cX� i p -, aU _irvs Ja+vices =' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] blank) 0 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMt 12.00 (PLEASE PRINT IN LAW OR TYPE ALL INFORMATIO111) Date: /Z —S--/I City or Town of: y Aft-enatrf 14 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) 8'7 6L.t/44T P"A-C-I(.'(_. (L i)�) Owner or Tenant o lei N CEO RA,t Telephone No. Owner's Address S i c- Is this permit in conjunction with a building permit? Yes ❑ No IEF-- (Check Appropriate Box) Purpose of Building S 141 t.e FA mi Lif Utility Authorization No. Existing Service Amps / Volts Overhead❑ 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: wt,r,E A,/G eohvoEn c oti -t- /ZEPC .(C"l cAr7 A-s Apt.'ts-C6 Completion of the followinktable may be waived by the Inspector of Wires. No.of Recessed Luminaires No.ofCeti.Susp.(Paddle)Fans Tr of Total Tr ansformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above ❑ In- ❑ No.of Emergency Lighting /ern& mud. 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. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Total Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ C al.ction ❑ Other No.of Dryers Heating Appliances KW S:; No.of�or Equivalent No.of Water , No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Na.of Motors. TolnI _ Telecommunications W' i�Ta-of Devices or OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start f Z -�I S 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 cov a is in force,and has exhibited proof of ff same to the permit issuing oce. CHECK ONE: INSURANCE �]BOND 0 OTHER 0 (Specify:) id 41" --"tC, g / I ce rify,under thspains and penalties of perjury,that the information on tkis application is true and complete. FIRM NAME: i L V G r cPC71.-I (_ LIC.NO.:n9/V 7 Licensee:)�h w fit-tits- __1-et_ _ Signature LIC.NO.: EZ-IC y 9 (Ifapplicablhe enter"exempt"in the license masher line.) Bus.Tel.No.:Se.S-Y Z P-`a g C' Address: ID ad tIjL i JQ7 gD S$-404/,c4i el U 25-43 AIL TeL No.:A-0 -36 c/- 13 i / *Per M.G.L.c.147,s.57-61,security work requires 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 required by law. By my signature below,I hereby waive this requirement I am the(check one)❑owner. ❑owner's agent SignatureOwner/Agent , Telephone No. I PERMIT FEE:$