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Home My WebLink AboutBLDE-19-005346 • Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-005346 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:3/26/2019 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) 17 BOXBERRY LN Owner or Tenant MACDONALD LINDA D Telephone No. Owner's Address 17 BOXBERRY LN,WEST YARMOUTH, MA 02673 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 New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install receptacle&replace fixtures in bath room. 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. 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 ❑ 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 ❑ BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Daniel J Burns Licensee: Daniel J Burns Signature LIC.NO.: 30280 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 328, GREEN HARBOR MA 020410328 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 k(r V-& „ (t 9 er--- frtyq ( '"' , C'" y.y i / ,i 40 tpY` sf\V pvs— /:vci,td _ C�ommor wira.[Ih off i i ta55achu5aft5 ,. Use Only J. i-,t Permit No. rcial 6?--,5 1 C I0,,-. cry�,, c7 n _!�__` 1Jeparitnent n f-qr.;..arvice5 = Occupan and Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS Occupancy. ; --- [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 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3 -- 2 — 7? City or Town of: YAR1VIOUTH To the Inspector of Wires: Ll' by this application the undersigned gives notice of his or her intention to perform the electrical work described below. I ' 1- • � 'i,ocation (Street&Number) /' /7 /3OA/3t2/2 L . ' m-v �wner or Tenant ��, � � .�'- �' . --. a a, d, "�•;,€_ �'.'' '•• /�a {.•f r_r� Telephone No. •�• wner's Address S`/ ',-1- I • \ii1 :"' this permit in conjunction with a budding permit? Yes �� 1 .\ a¢ ; ❑ No ❑ (Check Appropriate Box) 1 0 v ; o jurPose of Building /2k 13�Ci%VG Utility Authorization No. A- ) -- iv LU L.._o.,—,_b ---1 p filxisting Service Amps / Volts Overhead E. Undgrd❑ No.of Meters "-"•---- • "'View Service Amps / Volts Overhead❑ Undgrd gr ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed EIectrical Work: Z'A...;c/ L 741 /-7-fxz�s 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 ❑ Ia.. 'No.of-Emergency Lighting - srnd. arnd. ❑ 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 J 0 Initiating Devices V No.of Ranges No. of Air Cond. Total _ Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons_I KW No.of Self-Contained p Totals: Detection/Alerting Devices k No.of Dishwashers SpacefArea Heating KW Local p - ❑ Municipal ❑ Omer Connection Na.of Dryers Heating Appliances , S curity Systems:* No.of Water No.of No.of Devices or Equivalent w , Heaters KW No.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 detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: Work to Start: (When required by municipal policy.) 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 �1 ; the licensee provides proof of liability insurance includingsubstantialequivalent.may issue unless ^lJ undersigned certifies that such coverage 's in force,and has[exhibit d proofr of same tocove the permit rage or its sun ffiicee The 9 CHECK ONE: INSURANCE (y I certify, under the pains and penalireOo�er❑u OTHER ❑ (Specify:) _0I FIRM NAME;,O pains and fp J �''that the information on this application is true and complete.71/ 4v G�v2�s 92�7 Z � Licensee: ,�f'p LIC.NO.775: (Ifapplicabl enter"exempt"in the license number line) Signature LIC.NO. (� Q. Address. p efit3e- /2�S Sus.Tel.No.: .� Per M. L. c. 147,s.57-61,security work requires p Alt.Tel.No.: OWNER'S INSURANCEDepartment of Public Safety"S"License: Lic.No. Q5 required by law. WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— y , Owner/Agent By my signature below,I hereby waive this requirement I am the(check one ❑ g rurally I Signature owner 0 owner's a_ent ►! Telephone No. PERMIT FEE: $