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Home My WebLink AboutBlde-19-005604 Commonwealth of Official Use Only 1`; ', Massachusetts Permit No. BLDE-19-005604 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:4/8/2019 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) 25 PINE ST Owner or Tenant DARBY ELEANOR Telephone No. Owner's Address P 0 BOX 655,YARMOUTH PORT, MA 02675 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repairs or replacements due to water damage. (See attached) 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 god. 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 Securiq 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: PAUL MCGRATH Licensee: PAUL MCGRATH Signature LIC.NO.: 54687 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:25 BUCKWOOD DR,YARMOUTH MA 02664 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 Caebiac4vt & � 541l' . P 1 2G(( f Commonwealth of J'/laddecku.deltd Official Use Only �F=" c-� Permit No.��_S 1!p a �+!=_ 2epartment o{. Serviced 9\" --------.... :. .._-_-`_V— ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07j --- (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (ME ),5 7 CMR 12.00 t 'PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: y g�l q 4 ui c E7-: City or Town of: YARMOUTH To the Inspec or of Wires: I > c-; `- i13y this application the pndersigned gives notice of his or her intention to perform the electrical work described below. ;Location(Street&Number) 2 5 ?f ere. -s+reek z 7 '� caner or Tenant I Telephone No. 3 S7_30�_ HH �' ', Owner's Address ' Lid 'G.. - '„ 0 -„ , .' : Is this permit in conjunction with a building permit? Yes • ❑ No ® (Check Appropriate Box) purpose of Building Utility Authorization No. Existing Service Lop Amps 120 /240 Volts Overhead Q. Und d t;r ® No.of Meters New Service 200 Amps I20 /24Iv Volts Overhead❑ Und d gr 25 No.of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ++ 'tc.M�car �� j e�y ac` `^��'e� 1 c+cicc� SefviGL/ Sv., d� ct ot 'ck1j `erne�5 . Few•r t '15 is C cOrv� rc i 2n t �e r 1 c�w:a�g+F�,c�A Completion of the following table may be waived by the Inspector of Wirer. 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 Li No.of Emergency Lighting - arnd . 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 Total No.of Ranges No. of Air Cond. Tons No.of Alerting Devices QNo.of Waste Disposers Heat Pump_I Number I Tons I KW No,of Self-Contained Totals: I Detection/Alerting Devices V 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 Heaters KW No.of No.of 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 10: ' Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E ectrical Work (When required by municipal policy.) Work to Start: yiN/l9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 cover ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHERI certify, under the pains and enal ' s o ❑ (Specify:) FIRM NAME: r1r1 IaAgryyp fpe7lury,that the information on th. application is true and complete. �� IN1J4% 1 ‘C4q Licensee: �Gul �l✓c LIC.NO.: 6+ Signature f �— (If applicable.enter"exempt"in the license number line.) LIC.l. NO.: Address Bus.Tel.No.:�2y-7�y-ll __I *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage ormally 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner ❑owner's a ent. Owner/Agent al Signature. Telephone No. .• PERMIT FEE: $ �S^/