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Home My WebLink AboutE-19-5483 irtisCommonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005483 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:4/1/2019 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 jilocribed below. Location(Street&Number) 75 SISTERS CIR 'ply( T44-- Owner or Tenant S Telephone No. Owner's Address R . R , • Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 1z1 1 G ( i Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters �P 9 4 New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 20 No.of Ceil:Susp.(Paddle)Fans 3 No.of Total Transformers KVA No.of Luminaire Outlets 5 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 60 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 30 No.of Gas Burners 1 No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. 1 Total 1 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 1 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 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jarlath A Galvin Licensee: Jarlath A Galvin Signature LIC.NO.: 10861 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 100 ACORN DR, OSTERVILLE MA 026551370 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:$180.00 TLtIkrat 0 aupvir Viong 6((ot1(9 - e ; l�OnidiO,tfUSRL1Ii oI///aS6ac1tS1q Use Only - _ 0i— ^ • a " Permit No. '-� Q "_--t:E_= 2 pint o f. Sarvt s O BOARD OF FIRE PREVENTION REGULATIONS Ov`1�`y and Fee Checked -1�� ' ` IRev. 1/07) (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical ode C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ti la 19 City or Town of: YARMOUTH To the I ector of Wires_ -- - By this application the undersigned gi s no .ce of his her intention to perfo th electrical work described below. t �^� z Location (Street&N tuber) 7S C n.t I�____Zt o. .0 wW� I '� i Owner or Tenant �01.a.1 s ''��' ` ' '' Mt' n Telephone No. ,; „ (Owner's Address ?4 �tRe Au-sk kita�- isc M'1 °Lola ' 1 �;_�� 'Is this permit in conj ction wifh building permit? Yes ✓ No ❑ (Check Appropriate Box) Purpose of Building is Utility Authorization No. l Existing Service Amps / Volts Overhead ❑ Undgrd r,,,�s _ , l;r ❑ No,of Meters ,_.. ""i, New Service -Q- Amps Z,yO/ V1,,p Volts Overhead❑ Undgrd r >'r No.of Meters -F— Number of Feeders and Ampacity Li Location and Nature of Proposed Electrical Work: L Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires Rv No.of CeiL-Susp.(Paddle)Fans • No.of Total • Transformers KVA No. of Luminaire Outlets S No.of Hot Tubs Generators KVA No.of Luminaires 5wimmia Pool Above In- ❑ Po.oT Emergency Lighting grrnd. rtttd Battery Units No. of Receptacle Outlets 66 No.of On Burners FIRE ALARMS INo,of Zones No.of Switches 30 No.of Gas Burners ( No.of itiating Devi Detection and Inces No.of Ranges No.of Air Cond. Total _ Tons i No,of Alerting Devices No.of Waste Disposers Heat Pump]Number'Tons KW No.of Self-Contained - Totals:I Detection/Alertnu Devices No.of Dishwashers I Space/Area Heating KW' Local❑ Muaiclpal _ Connection ❑ r No.of Dryers GS. Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent Heaters KWNo.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional derail if desired or as required by the Inspector of Wires. Estimated Valu of E c Racal Work: 2.0 oee (When required by municipal policy.) •Work to Start: 11 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C VERAGE: 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 cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [ BOND 0 OTHER I certify, under the pains and penalties o ❑ (Specify:)fper perjury,that the information on this application is true and complete. FIRM NAME,NAMEC..j LANK QAt...0 is Licensee: �/� E1 LIC.NO.: 0 WtN Signature i tN LIC.NO.: p (Ijapplicable,ooenter(ezempt in a licentq,v tuber f�.) Nt wl MA 0% Bus.Tel.No.:• Address: j "Per M.G.L. c. 147 s.57-61,security work re fires D AIL Tel.No.: S INSURANCE Department of Pu tic Safety"S"License: Lic.No. �z OWNER' CE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage nnoortnally required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner Owner/Agent El a ,� Signature ent. Telephone No. PERMIT FEE: $