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Home My WebLink AboutBLDE-19-001537 ^-'" Massachusetts Commonwealth of Official Use Only �E Permit No. BLDE-19-001537 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:9/13/2018 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 electncal work described below. Location(Street&Number) 180 SOUTH ST Owner or Tenant KAMBORIAN LISBETH N Telephone No. Owner's Address 151 MASSACHUSETTS AVE,ARLINGTON, MA 02474 Is this permit in conjunction with a building permit? Yes 0 No 0 (f Ali Appropriate Box) Purpose of Building Utility Authorization irill. AN, Existing Service Amps Volts Overhead 0 Undgr !li ► eters New Service Amps Volts Overhead 0 Und 1 • ■ i 'v • • Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Remodel following water damage. izo8 4•Completion of the following table ,1, ,Zs, e Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of 0 Totalal Transformers 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 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: DAVID W SPRINGER Licensee: David W Springer Signature LIC.NO.: 21170 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:70 Bishops Ter, Hyannis MA 026012106 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:$75.00 . 0 \_ / Comrno►cwra of Massachusetts cial Use Only 5-3 ii,___ _ ., `= /c7 [� Permit No. J ‘,N43 an'_= - 2eparimeni o1',}ire Services t-f= ``• ' 'Y,,,-;T BOARD OF FIRE PREVENTION REGULATIONS Occupancy] -and Fee Checked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 52 CMR 12.00 (1v11*C), (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 1 I t 3 i $ City or Town of: YAR1VIOUTH 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) \.ii 6 So u 4\ S k S yA CP1GU J Owner or Tenant ?j- ,k'Su� Telephone No. LOwner's Address J Is this permit in �+J�conjunction with a building permit? Yes No ❑ (Check Appropriate Box) CI Z • urpose of Building (� I1i�) Utility Authorization No. t `�� i xisting Service Amps / Volts Overhead ❑. Undgrd ,F gr ❑ No.of Meters \o ew Service ❑ Undgrd ❑ No.of Meters �` ?e � Amps / Volts Overhead 0 *umber of Feeders and Ampacity Ll O Vocation and Nature of P op sed Electrical Work: Completion of the following table m be waived the Inspector ofWires. _� a1 by P e ea Nio.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.01:Emergency Lighting gird rind. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and •• Initiating DevicesTotal _ No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained • Totals:I �" Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Q Connection ❑ � No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent No.of No.of Heaters KW 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 o Elec 'cal Work: c,C.)0O, t.. (When required by municipal policy.) Work to Start: 12 S 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 cove ge 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 ofperjury,that the information on this application is true and complete. FIRM NAME: sec t r Of,(" 1,L.e c.kcrC, LIC.NO.: Z -]O A Licensee: Sp a-,.\ ''�J�� "lC C�n�� Signature LIC.NO.: 3Z ct (If applicable,enter"ezAn`�1 in the li erase number li .) Bus.TeL No.: K SG 1I o(3°‘ . Address: 70 h +CC. 4 .At^� : ,J "Per M.G.L. c. 147,s.57-61,Security work requires a artment of Public SafetyAlt.Tel.No.: P "S"License: Lic. No. �z OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's [ 7 Owner/Agent Signature Telephone No. I PERMIT FEE: $ f 1