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HomeMy WebLinkAboutBLDE-19-006876 0. Commonwealth of Official Use Only ''IL: . Massachusetts Permit No. BLDE-19-006876 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:6/5/2019 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) 62 NEARMEADOWS RD Owner or Tenant BURKE EDWARD F Telephone No.Owner's Address CIO BURKE BARBARA A&ROBERT E,3 BEACONSFIELD DR, NATICK, MA 01760-2805 Al� ` 0(J,/,',T16 Is this permit in conjunction with a building permit? Yes 0 No El (Cl•tetet 4 B f 1�'t�:/V Purpose of Building Utility Authorization Na ; 7_` r Existing Service 100 Amps Volts Overhead 0 Undgrd El " Ietersy v� • New Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service panel&relocate 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- El 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. 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 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 ifdesired,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: Robert F Eagles Licensee: Robert F Eagles Signature LIC.NO.: 20213 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:229 CARVER RD, PLYMOUTH MA 023605285 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 _* Corn ioruuea o1 fftassachusetts • Official Use Only -_ ��- ..CJcpartmarrf al tine J Permit No. arvices =f= Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. l/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: 6/ /.// ' 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) ‘.0 %' ,4 i , /`2 ' Owner or Tenant J N k �c( Telephone No. p 3758 -3?7/V7 Owner's Address 3 e.fQ ,..„, ke er-i _ c/I/44ki�,f„ ©/'7 Is this permit in conjunction with a building permit? N. `Yes 'U / ❑ No � (Check Appropriate Box) Purpose of Building Du..e is Utility Authorization No. 7FY��ift j O 7 Existing Service/c p Amps /o ,/olQr Volts Overhead Undgrd ❑ No.of Meters New Service /no Amps /AC /01.(58 Volts Overhead 0' Undgrd gr ❑ No.of Meters _i___ Number of Feeders and Ampacity a "o2 Location and Nature of Proposed Electrical Work: e, �� C J-(p-Cc t—l� .� �` f (� t�, „re....„, ., Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeiL-Busy.(Paddle)Fans No.of Total Transformers KVA _ No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmin Poo! Above In- ❑ No,of Emergency Lighting g rrad. ❑arnd- Battery Units No.of Receptacle Outlets �t, No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches 1a No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump 1 Number I Tons_J nt KW No.of Self-Coained Totals:I —] Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No. No.of Data Heaters KW of 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 of Electri al Work: .?JO 0 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C GE: 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 0 OTHER ❑ (Specify:) I certify, under the pal an penalties erfary,thal the information on this application is true and complete. FIRM NAME: LIC.NO.=__43_ Licensee: _ efri �e'" Signature - (If applicable.enter"exempt" t e licerrl number fin ) LIC.NO.: Address: //�JCC az � Q` Dci ` ��,/c ,t` �0 Bus.TTel.NNo.: S/O ent of Public j {Safe[tyy"S."License: Alt.L c.No. .---- ,.,;c— OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norm— ally S required by law. By my signature below,I hereby waive this requirement. I am the(check one ❑owner o Owner/Agent ❑owner's a ent. Signature Telephone No. PERMIT FEE: $ I