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Home My WebLink AboutBlde-19-003158 Commonwealth of Official Use Only E. ` Massachusetts Permit No. BLDE-19-003158 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:11/21/2018 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 electrical work described below. Location(Street&Number) 115 SETUCKET RD Owner or Tenant ANCAHAS DANIEL J Telephone No. Owner's Address ANCAHAS SARAH C, 115 SETUCKET RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ✓ rate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 o. ... • Rif) New Service Amps Volts Overhead 0 Undgrd • . AM; Number of Feeders and Ampacity `✓v F 7 Location and Nature of Proposed Electrical Work: Wiring for addition. 0 O O Completion of the following table may be wa ,y ,ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of A tal Transformers A No.of Luminaire Outlets 4 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 16 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 6 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: John P Antone Licensee: John P Antone Signature LIC.NO.: 32046 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:205 JONES RD, MARSTONS MLS MA 026481045 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 1\1 11A. 1((Z3l e k jc60G il �s (ig ( • Com+norwisa[th oiassacfts Official Use Only ' ��= Apartment o yi►�s Serviced Permit No. v ` ` I�� _!'=_• f -- BOARD OF FIRE PREVENTION REGULATIONS Occupancy 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: City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives ce of his or her intenti yo perform the el "cal work described below. Location (Street&Number) l/- jFTi' i2 at' 608 Owner or Tenant & -C 3 � Telephone No. Owner's Address 115 E7- E'r ) 4/1104)-fii 1K?7 UaG TS Is this permit in conjuncti with a building permit? Yes `�lo ��/�1��, ❑ (Check Appropriate Box) Purpose of Building /A'L Utility Authorization No. Existing Service/9 AmpsbO Bolts Overhead LJ. Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd gr 0 No.of Meters Number of Feeders and Ampacity / Location and Nature of Proposed Electrical Work: Jr�o )9h Wit//�g "told-7 i ld I riovs /` 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 }� SwimmingPool Above In- No.oTmergency Lighting grad.. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets 1 ito No.of Oil Burners FIRE ALARMS 1No.of Zones No.of Switches 110 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 Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW• Loral❑ Municipal Connection ❑ °ther No.of Dryers Heating Appliances KW Security Systems:* No.of Water , No.ofNo.of Devices or Equivalent Heaters 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 Estimated Value of Electri al W,; d� — Attach additional detail if desired or as required by the Inspector of Wires. Work toStart: (When required by municipal policy.) SURANCE O Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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: INSURANC ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains penalties/'� of, ury,that the info • n o, . : , FIRM NAME: / f Op 'ication is true and complete. Licensee: �0 D lY l LIC.NO.: e Signatur Ear •W(If applicable,enter"erem t"in he lie q number Ii e) LIC.NO.: y Address: _ { it l , q A 0��g Q Bus.Tel.No.: J .Per M.G. .c. 147,s.57-61,security work requires Department of Public SafetyU Alt.Tel.No.: i4 � OWNER'S INSURANCE WAIVER: I "S"License: Lic.No. required by law. Bymysignature am aware that the Licensee does not have the liability insurance coverage rim im4aily— gnature below,I hereby waive this requirement I am the(check one Owner/Agent 0 owner 0owner's a Signatureent Telephone No. PERMIT FEE: $ `f , Gjj