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Home My WebLink AboutBlde-19-001944 of Commonwealth of Official Use Only fi , Massachusetts Permit No. BLDE-19-001944 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:10/2/2018 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 describ••below.r. ''// ,,,�,�`/`� Location(Street&Number) 28 SHERIDAN RD ivl <<, ANC 77�� `� `Y'1z- Owner or Tenant LIBRANDI SIBYL Telephone No. Owner's Address -:_ 6 WAVEY WILLOW LANE,MONTGOMERY, NY 12549 O Is this permit in conjunction with a building permit? Yes 0 No 0 (ChAp rop I Purpose of Building Utility Authorization No ExistingService Amps Volts Overhead 0 Undgrd 0 '1 of.' • firA r P _ New Service Amps Volts Overhead 0 Undgrd 0 '• _ 'Mat. Number of Feeders and Ampacity e g Location and Nature of Proposed Electrical Work: Repair or replace storm damaged equipment&wiring. i Completion of the following table may be waived by the 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- I: No.of Emergency Lighting grnd. grad. 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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 perjug,that the information on this application is true and complete. FIRM NAME: Glenn W Crafts Licensee: Glenn W Crafts Signature LIC.NO.: 10020 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:72 COUNTRY CIR,SOUTH DENNIS MA 026602920 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 - Common.wea�o`///aadac1 udetLs Official Use Onlynl + t` cc�� cc77 Permit No. C L9— 1 14q ___ li t 2)epartment o/,.tire Serviced • t1_ ; Occupancy and Fee Checked Y : ,, BOARD OF FIRE PREVENTION REGULATIONS 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 CM 12.00 (PLEASE PRINT IN INK OR T`Y,IE ALL INFORMATION) Date: q —al City or Town of: "l'.Y"iM0L)41.A 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) 2Lj k.piv-i AanA_ Rq94/2._ Owner or Tenant 13 r i 0.h C.i to CAva i Telephone No. Owner's Address 74 tS ,D Q.v.vk i S VA/ S 1O,,Pwta 04.k 1V J D ZLoL.o Y Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building I rtiAnn,'b eilt J Utility Authorization No. Existing Service /OD Amps //5 /Z3o Volts Overhead IJ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity �J Location and Nature of Proposed Electrical Work: geetat�.e. C�,\pX�jl"De,v i c S �r''tp'r' ieie by It +��; Zk: A- 1- G.e, E�cw if `Rro kAdot Q as Klock)1- Completion of the following table may be waived by the Inspector of Wires. otal No.of Recessed Luminaires No.of Ceil:Sus (Paddle)Fans No.ofTVA P Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires swimmingPool Above r—i In- 0 No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones oNo.of Switches No.of Gas Burners No. Initiatingon nDete and Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number 'Ions KW No.ofSelf-Contained P Totals: I } Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local❑ Municipal ❑ Other P Connection No.of D ers Heating Appliances KW Security S stems:* Y No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent dromassa a Bathtubs No.of Motors Total HP Telecommunications Whin No.H Y g 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: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 0 BOND ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: G(,`S,r( LIC.NO.: `(}no Pt Licensee: CAt,N C r kk�s Signature9S,A,L, I, LIC.NO.: "1 1yy (If applicable,enter "exempt"in the license num er ine.) Bus.TeL No.:SOb Ny k4( Address: 'a.S'\ (.)f t A \►i t��tt 4MO VieANA Wt. 0-1..fl+v Alt.Tel.No.:Sp:, Wo SS S *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. '�-a` y