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Home My WebLink AboutBLDE-19-004446 :- .„ Commonwealth of Official Use Only Permit No. BLDE-19-004446 41.�, Massachusetts !zes:;7BOARD 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:2/4/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention t rtorm the elec al work described below./_Q 3.....9 3 0...,„ Location(Street&Number) 141 SEAVIEW AVE � P-4 laNn ce (� 1 ````��"'� Owner or Tenant HOFFMAN CHRISTINE M Telephone No. Owner's Address 131 SEAVEIW AVE, SOUTH YARMOUTH, MA 02664 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: Modular home, service&grounding. 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. 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 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 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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:$230.00 R_Mi2 Ql/-Du, iAJ yea6? if �� -(L oc,L tva_ J`() 6/fi fi9 r Commonwealth of//laddac ffs • O cial Use Only �i / 1JsparfinenE o{ S' Permit No. _ Services TE ' BOARD OF FIRE PREVENTION REGULATIONS Ov. 1/07ry and Fee Checked ,' •`- ,[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: p City or Town of: YARIVIOUTH / 3`��/ ` To the Inspector of Wires: 0 . .�___...._..,__4,this application the pndersigned gives notice of his or her intention to perform the electrical work described below. 2. -72 ,odatioa(Street&Number) r / Y1 54"/yd1pli 4t/ <;- Owner or Tenant �,L,ud7 ,¢ 1 L L G cAfri[[ _ Telephone No. . /�. t 4 ,, Owner's Address /c// Sc'a✓yCi✓ Ate `. Is this permit in conjunction with a building permit? Yes r✓ — No ❑ (Check Appropriate Box) _ Purpose of Building Air Ad t4opir Ca,V s rAv or m A..) Utility Authorization No. L tf_ Existing Service Amps p / Volts Overhead ❑ Undgrd❑ No.of Meters New Service d Amps // ) l ILO Volts Overhead XI Undgrd t;r ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Alo path Ng NE /tic Sri2Uier 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 Lightrng ern&. srnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. To Tons No,of Alerting Devices No.of Waste Disposers Heat Pump Number Tons I KW No.of Self-Contained TO : I ! Detection/Alerting Devices a No.of Dishwashers Space/Area Heating KW' Local❑ Municipal h Connection ❑ �r' v No,of Dryers Heating Appliances KW Security Systems:* Nv No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: \ Signs Ballasts No.of Devices or Equivalent r No.Hydromassage Bathtubs Na.of Motors Total HP Telecommunications Wiring: - OTHER: No.of Devices or Equivalent N Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work S/ D e U (When required by municipal policy.) kWork to Start: - -m ici Inspections to be requested in accordance with MEC Rule 10,and upon completion. k, 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 ❑ OTHER. 0 (Specify.) SI certify, under the pains and penalties of perjury,than the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (A e (If applicable, enter "exempt"in the license number line.) Address. Sus.Tel.No.: ! Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyAlt.Tel.No.c. : OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability i ranc coverage n�ly S required by law. B signature b ow,I hereby waive this requirement I am the(check one owner ❑owner's a ent Owner/Agen al Signature . Telephone No. r,,0)13d- 19 PE IT FEE: $,s�ti