The URL can be used to link to this page

Home My WebLink AboutBLDE-19-006763 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-006763 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:5/30/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below.Location(Street&Number) 129 OLD MAIN ST Srb —rI/ (oo^'27 314 Owner or Tenant WASGATT ANN LAURA Telephone No. Owner's Address 15 STARK RD,WORCESTER, MA 01602 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 Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Add on Air Cond. 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 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 Initiatine 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 Siens 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: 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 Si'3/( t A- ie(3(e9 0 --- Ys-7(9 cam. 97 ' of///asaee.11a Official Use Only '' - -'' c� p Permit No. q—lp 7(7_, -4 = �C1,,„wh..wt of_ti,..Ja�vfc.s • 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 CMtt 12.00 (PLEASE PRINT INIIVK OR TYP ALL INFORMATION) Date: 5-` "Z-3 //d:'' City or Town of: ' 2404'f 1,1- To the Inspector of Wires: By this application the undersi Li,-• gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) / 7 00_2 is/Pt/ S7 S. (/asc.-7o../i/J Owner or Tenant ,4,J/,(/ I.9-4.0-4- Gt/4-Seia77 Telephone No. Owner's Address Sd"'1(_, Is this permit in conjunction with a building permit? Yes ❑ No E" (Check Appropriate Box) Purpose of Building S/N1(-4.. j-/.) leas Utility Authorization No. Ex Service Amps / / Volts Overhead- Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters Number of Feeders and Ampacity 8 Location and Nature of Proposed Electrical Work: I1/i 04/C &n/pL•✓Se t C" Completion of thefollowingtabk may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans To.o ransformers CAI CI % No.of Luminaire Outlets No.of Hot Tubs Generators KVA NI I No.ot Enmei:geney Lighting No.of Luminaires Swimming Pool and.e ❑ ❑. Battery Unit 4 No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices No.of Ranges No.of Air Cond. Tel No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Debxtion/Akrtin Devices V) No.of Dishwashers Space/Area Heating KW Local❑ C nnection ❑ Other recuritNo.of Dryers Heating Appliances KW s: No.oP=es or Equivalent No.of Water KW No.of No.of Data Wiring: 1 Heaters Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors TotaLHP- I4W of De.:w. Ey®'.Aent OTHER Attach additional detail U.desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Z 3 i f 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 same to the permit issuing offs CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) IdK' dr uC -1-014r 8/1' I certify,under ttrepains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: S i'-.VAl- C Lee;a.l LIC.No.:n9/V 7 Licensee:) PSI (Al Std-d/4- J.. Signature . LIC.NO.: EZl6 (9 (Ifappl enter"exempt"in the license mmdber line.) Boa.Tel.No.:SOS-V Z k-?4I C Address es a6 thit-A 144 Rio S49-///oc✓ee.L P7B 0 23"4? AIL TeLNo.:�O5r-3dh (/-= 931 / *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 h ceck one)❑ow Owner/Agent ( e ❑owner's agent. Signature Telephone No. I PERMIT FEE:$