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Home My WebLink AboutBLDE-19-001387 .l '7 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-001387 �� _ 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:9/6/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or V.-intention to perform the et,e.,ct�'cal work described bel w. Location(Street&Number) 74 HATCH RD ( 706 2EN.'4 2ZZ d r '361 - 3 Lf 5"-Z, Owner or Tenant SMITH CHARLANN M Telephone No. Owner's Address C/O CHARLES ZECCHIN TRS, 188 GLENDALE AVE,WINSTED,CT 06098 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: Replacement furnace. 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 1 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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: SHAWN A SOUZA Licensee: Shawn A Souza Signature LIC.NO.: 39768 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:31 LAKE DR, PLYMOUTH MA 023605648 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:$50.00 G !8 I `? (5((9 ee6 Q(4t, i. 3 ( 1R ( 3 ? * V/ C� Com+nonmsafr/s of//la.4.4achxusslfs Official Use Only --.4.. il.---;--_!---=- .5/ el= .(! l Services Permit No.`J� 1 ri---3 g 7 a�arfnsa o BOARD OF FIRE PREVENTION REGULATIONS . l/Oncy.and Fee Checked (Revev. /07] (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/ (/5 City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the►,indersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) J c /Ctt2i�.cv Owner or Tenant L.( SM i+ Telephone No. 4-0- 1.3 Owner's Address ckfuNe Is this permit in conjunction with a b din ermit? Yes$P ❑ No (Check Appropriate Box) t-Q1 Purpose of Building Jt'r.J , �.((i Utility Authorization No. `.." Existing Service Amps / Volts Ove d ❑ Undgrd❑ No.of Meters New Service Amps ! — Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity p=---- Lo9Ai� ddN`a re of Proposed Electrical Work: l,Uy`e f„, '��,� �e� /+ S w t Q = i i • Completion of the following table may be waived by the Inspector of):fires. o No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total •.�` c" 1 Q i Transformers KVA w No.of Luminaire Outlets No.of Hot Tubs Generators KVA LL[ , t o . w z No.of Luminaires Swimming Pool Above ❑ In- 0 'No.of J mergency Lighting ,� \ grad-. rind Battery Units w Iv o I No.of Receptacle Outlets_ No.of Oil Burners FIRE ALARMS 1No.of Zones G .; No.of Switches No.of Gas Burners No.of Detection and ce - _.. _. 1 I1nitiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump!Number I Tons_j KW No.of Self-Contained Totals:I j Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW• Municipal Low❑Connection ❑ other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of Heaters ' No.of Data Wiring: 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 7Eleptii al Work` OD OCZ:. (When required by municipal policy.) Work to Start: ' (cr 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 i ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove e 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 airs and penalties o perjury,that the information on this application is true and complete. FIRM NAM c. ti • c . jam' 1 C) . U LIC.NO.: ! b Licensee:�� ^i;�j„�-. GL- Signatu (If appllcab{eLegter"ex pt"in th !i ease rru r line.) i LIC.NO.: 3! 2 C . Address: S( Ic IGZ ,Pi&, Y Pio-t(,\ Al 9 15 r But.Tel.No.: 7 G -4/6 g J Per M.G.L. c. 147,s.57-61,security requiresAlt.Tel.No.: work 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(check one)❑owner 0 owner's agent Owner/Agent I Signature Telephone No. I PERMIT FEE: $ lj6