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Home My WebLink AboutBlde-19-004389 g Commonwealth of Official Use Only -s iaf - Massachusetts Permit No. BLDE-19-004389 59, 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:1/30/2019 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform t�el. cctrical wor scribed below. Location(Street&Number) 112 BAXTER AVE J(9E'(-n/ Ni Owner or Tenant MANIATES PETER TRS Telephone No. Owner's Address MANIATES PENELOPE TRS, 112 BAXTER AVE,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: Basement bathroom, exhaust fans,furnace,water heater&replace lights& devices in kitchen. 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 ❑ 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 ❑ OTHER 0 (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: DANIEL J PECKHAM Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in the license number line.) . Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 e - (1?V�% (Ai d 6 r. „.es (A, gA-h (1 .,,, st, t tl?5 erehux.) 81z- 0 ize_ 4-0411 e(8 667 e (Fimot_ cd_s. (40/ (1/.90!e�) Commonwealth o //lassacft s Official Use Only • � � — , ��_ .2aparf „„t 4.tirs C� Permit No.� Lf_ j• Services 1i BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] blank) . (leave APPLICATION FOR°•PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / (-2,0//`Z City or Town of: YARIVIOUTH To the Inspector of Wires: By this application the t,indersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 1 1 ( ,_x`- A. a tI , Owner or Tenant ""jn 1 n 6 L , Telephone No. t(TT'pvner's Address -Is this permit in conjunction with a budding permit? Yes E No 0 (Check Appropriate Box) �•: - ?ut s /pose of Building Utility Authorization No. '^ - �Ezfstiag Service Am F Volts Overhead ❑ Undgrd❑ No.of Meters 4 '`�'` ` =New Service Wo Amps / Volts Overhead❑ Undgrd ❑ No.of Meters <, " =NtRmber of Feeders and Ampacity 1, �, Location and N tore of Proposed Electrical Work: p _ 4 �••. _ � /� � 1 c�N Ytf C.G 33 7F_� R.,.pi„G t !rl✓/-t.f/.f�- e_-_... �tre ireLC.5 41;;il-.f PY Sir»/A' /t/s t.01./AlT/ !.0 BGA -4i2 6V . ,-i/c�ttL n-C T,t/L �c n./ n _„ [ vQ�t -t- �c Completion)the following; 1e may be waived Iry the Inspector of Fires. No.of Recessed Luminaires No.of Cei1-Susp.(Paddle)Fans No.of Total Transformers !{VA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- "No.of J mergency Lighting arnd. rrnd. Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS f No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tun No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons f KW No.of Self-Contained Totals:l Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local D Municipal Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent 1Heaters KW No.of Data Wiring: Sighs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: l• OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Pares. Estimated Value of Electrical Work (When required by municipal policy.) , Work to Start: Inspections to be requested in accordance with MEC Rule l0,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. e CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) 11) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: ; ' 3 Signature i �°�t f (If applicable.enter empt'in the license number line.) � �` .. LIC.NO.: - Address ?A,> .r ,,.. 5 us,. p� y� k Bus.TeL No.: .j *Per M.G.L. c. 147,s.57-61,security work requires Department of Public SafetyAlt TeL No.:.S aSc 7 565-- 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 El owner ❑owner's a ent Owner/Agent ' Signature Telephone No. PERMIT FEE: $