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Home My WebLink AboutBlde-20-003188 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-20-003188 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:12/3/2019 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) 62 SILVER LEAF LN Owner or Tenant WARD HENRY JOHN Telephone No. Owner's Address WARD NORA,62 SILVERLEAF LANE,WEST YARMOUTH, MA 02673 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: Repair or replace existing wiring in basement apartment. 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 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: William C Fligg Licensee: William C Fligg Signature LIC.NO.: 12584 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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,1 hereby waive this requirement.I am the(check one) 0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $200.00 O A/54, _. l,minonumult s of Maddach.40th • • Official Use Only at o{.J7ir+r Services Permit No. J^� f 2Tc:rinse ____ILAt) BOARD OF FIRE PREVENTION REGULATIONS , .Occupancy and Fee Checked t/07] eave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL D FORMATTOI) Date: City or Town of: YARMOUTH To the I ect r of Wires: . By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Al t.l .0 1,,+ Owner.or Tenant I--1.LA.A r1 WC-- Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes E No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Ua dgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wo l-k: Vt ri r-„,p.tui,.. E.,_iSi-‘,,.4% Cr.)Li'1(44....S Completion of the follcnving table may be waived Ey the I No.of Recessed LuminairesInspector of ii'ires. No.of Cell.-Snap.(Paddle)Fans No.of Total Transformers KVA No.of L uminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming pool Above In- Nan.of emergency Laghtmg :gad. grad. Battery Units No.of Receptacle Outlets No.of OR Burners w FIRE ALARMS No.of Lanes No.of Switches No.of Gas Burners No.of Detection and Initiative Devices No.of Ranges No.of Air Cond. Total . Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained — Totals: _Detection/Alerting_Devices No.of Dishwashers Space/Area Heating KW' Local❑ Municipal Connection 0 Other No.of Dryers Heating Appliances , Security Systems:* No.of Water , No.of No.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 • ly Attach additional detail if derired or as required by the Inspector of Wires. Estimated Value o El trical W oi (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unl• the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The s undersigned certifies that such covers a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [• BOND ❑ OTHER 0 (Specify:) I certify, under the pains and e a ) ( � p/► s f perltt that the information on this application is true and complete. FIRM NAME: j l ,.— ,(.4 ke hivGkc1,:--) Licensee: � C � LIC.NO.: 2... .." Signature LIC.NO.: (if applicable,enter"exempt"in the lice= tuber line.) Address: Bus.Tel.No.: Se i Per M.G.L. c. 147,s.57-61,security work requires Department of Public Saf Alt.Tel.No.: �s OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabili Lin.No. required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner n ly Owner/Agent ❑owner's i Signature