The URL can be used to link to this page

Home My WebLink AboutBLDE-19-005552 Commonwealth of Official Use Only A. , Massachusetts Permit No. BLDE-19-005552 '`�0 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:4/4/2019 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) 60 HARBOR RD Owner or Tenant KEELEY DENNIS L Telephone No. Owner's Address KEELEY KATHY A,47 GARNET RD,WEST ROXBURY, MA 02132-1318 Is this permit in conjunction with a building permit? Yes ❑ 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: Wiring for split NC. 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 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ 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: DANIEL J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 V \v _ Common.cusalth of///assac ffs Official Use Only I-1 0\'‘)' i._-_--_ --„--_-_„. _=_ ei / 2eparfinsni al s Permit No.E�tR' "f�5� f , Serviced { Occupancy and Fee Checked �s- BOARD OF FIRE PREVENTION REGULATIONS {Rev. l/O7) --- (leave blank) APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Y j 9. City or Town of: YARMOUTH To the I ect r of Wires: By this application the undersigned gives notice of his or her inte tion to perform the electrical work described below. Location(Street&Number) (,o 1,,,,,,A_A & k Owner or Tenant ca),.i ,,,t i . tC,.,G Cry GGGLLL Telephone No. Owner's Address Is this permit conjunction with a building permit? Yes .. , . _. ... in ❑ No ❑ (Check Appropriate Box) ~P rpose of Building Utility Authorization No. " z: „l, E E )sting Service Amps / Volts Overhead ❑ Undgrd s N w Service gT ❑ No.of Meters 6 Amps / Volts Overhead❑ Undgrd ❑ No. of Meters PI tuber of Feeders and Ampacity ter, a' , cation and Nature of Proposed Electrical Work: " / G. i , y Completion of the followin&table may be waived by the Inspector of Wires. 7; No.o fo.of Recessed Luminaires f CeiL-Busy.(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 le.mergency Lighting - arnd. rid.g ❑ Battery Units 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. Total • Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number KW No,of Self-Contained Totals:I I Tons ' Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW Local❑Connection 0 Omer No.of Dryers Heating Appliances , 'Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters KW 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 desires;or as required by the Inspector of Wires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCES BOND 0 OTHER ❑ (Specify:) I certify, under the pains and pen tes of perjury,that the information on this application is true and complete. FIRM NAME: Licensee:br LIC.NO.: (If Licenlicabl enter exe t in the license number line.) Signaturecji0.�,/a�p, LIC.NO. r Address: /� Y bT, L in. Yuci�5'C�. /yip( ., €, �44'� Bus.Tel.No.: J *Per M.G.L. c. 147,s.57- security work rewires Department of Public SafetyAlt.Tel.No.• - S <z — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverally S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑ownero Owner/Agent 0 owner's a eat Signature Telephone No. PERIIIIT FEE: S I