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Home My WebLink AboutBLDE-19-006478 Commonwealth of Official Use Only Ems,I stMassachusetts Permit No. BLDE-19-006478 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:5/15/2019 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 described below. Location(Street&Number) 207 STATION AVE Owner or Tenant AR GT , i &RUTH M Telephone No. Owner's Address C/Q v 1.1,612 PLEASANT ST, RAYNHAM, MA 02767 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: Garage to family room, bathroom,&laundry. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires 4 No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 2 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 10 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 10 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 1 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:) qi I_.7/,f g 14 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. "'`�' FIRM NAME: Shawn P Perkins Licensee: Shawn P Perkins Signature LIC.NO.: 13907 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 WOODHAVEN ST, CARVER MA 023301356 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 'fit q<0 ill RI (24r. ti N...) = --= l.,onsn:orswsaitls of Ma.65achusal2`3 • Official Use Only �� S C ct -(pq -2 6 imi_ 26;6=4-meld o iro Permit No. i -_ —t Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 7S (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts EIectrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: .S//s //9 -0 City or Town of: YARMOUTH To the Inspector of Wires: _ By this application the i,rndersigned gives notice of his or her intention to perform the electrical work described below. - Location (Street&Number) f Owner or Tenant M v c/o C- K Telephone No. ,_ Owner's Address s/3".C Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 6/}%f)6 ( co A✓✓AJ i# Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead E Undgrd g ❑ No.of Meters Number of Feeders and Ampacity Location and,/Nature of Proposed Electrical Work: 6a//a 6 C f3 ✓�7/!r� y� ��-w// 6�°^ 1/�'J'� J—,, "4/1'1 /i ll:". Completion of the follawinf table may be waived by the Inspector of Wires. No.of Recessed Luminaires y INo.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 0 In- No.of I"mergen Lighting - =Ta� crud- 0 Battery Unitsry No.of Receptacle Outlets /0 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches / 0 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers To tals: 1 Number Tons H KW No.of Self-Contained Detection/Alerting Devices t, No.of Dishwashers Space/Area Heating KW Local❑ Municipal - Connection ❑ Other No.of Dryers / Heating Appliances KW Security Systems:* No.of Water No. of No.of Devices or Equivalent Heaters KW No.of Data Wiring: - Signs Ballasts No.of Devices or Equivalent T No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent f. Attach additional detail if desired or as required by the Inspector of Wires. V Estimated Value of Electrical Work: a J-00 (When required by municipal policy.) Work to Start: ..0/r//�'j 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 V , the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. P^ undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. The V CHECK ONE: INSURANCE a® BOND 0 OTHER I certify, under the pains¢ d penalties o ❑ (Specify:) P of that the information on this application is true and complete 91) FIRM NAME: S 4 L.44 r//G7,vI ' Licensee: S Wei LIC.NO.: /1 Po) i C�/��^i Signature —� (If applicable, enter "e=empt"in jhe Eicense number line.) LIC.NO.: /f 762 Address c.Licensee: �f v�„� J G��wr/ Bus.Tel.No.:_? �/y1 /77 I *Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyO `License: Tel.No.: OWNER'S INSURANCE WAVER: 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 ❑owner ❑owner's anent Owner/Agent Signature —�. Telephone No. PERMIT FEE: S.