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Home My WebLink AboutBlde-19-002052 Commonwealth of Official Use Only �►i_ Massachusetts Permit No. BLDE-19-002052 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:10/5/2018 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) 16 COSYHOME TERR Owner or Tenant WILLIAMSON STEVEN E Telephone No. Owner's Address WILLIAMSON MARY JEAN, 16 COZY HOME TER,WEST YARMOUTH,MA 02673 Is this permit in conjunction with a building permit? Yes 0 No 0 (ChedtApimerige Box) Purpose of Building Utility Authorization No. 7 Existing Service 100 Amps Volts Overhead 0 Undgrd 0 ' " e.o `' ers New Service 100 Amps Volts Overhead ID Undgrd 0 No.of Meters Number of Feeders and Ampacity 4,4"/.3Sql,Location and Nature of Proposed Electrical Work: Upgrade serviceCompletion oft ." • �•• .Oactor of Wires. f Ceil:Sus .Paddle Fans No.o �� otal No.of Recessed Luminaires No.o p( ) Trans o rs VA O No.of Luminaire Outlets No.of Hot Tubs Generators nKVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighti 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 Sinus 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: LLOYD R SMITH Licensee: Lloyd R Smith Signature LIC.NO.: 15688 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:30 1ST ST, MELROSE MA 021764010 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:$50.00 q(e_ i/4 C.ommonwaaC t of MaaoacItuoetto Official Use Onl r� c'7 �\j ��— � lii ..Cl Permit No. .Y opavtment of,.tiro&,v c.o 7? Occupancy and Fee Checked »;,may �:' BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME 5 7 CMR l2 0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I H �1 > City or Town of: 1,0E "-'Liq ry,o To the Inspector o Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Ar 622y,-..4twL- ! , Owner or Tenant / (lr�•1 /,4Jli.Lt4,?,$ Telephone No. N�.7 . -5 Owner's Address ,. _ CA .S pv- . Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate BoxA Purpose of Building (AU.)" 1 1‘ f`/ /.3 Utility i uthorization No.c9p' (p3 'l l Existing Service/pa Amps 12-0 I2_' 4O Volts Overhead Undgrd❑ No.of Meters / New Service /00 Amps /a0/ ,2vOVolts Overhead/ Undgrd 0 No.of Meters / Number of Feeders and Ampacity /-7414t dj y Location and Nature of Proposed Electrical Work: / , o uG i (kJ IAA// a.s (e 4.!•.L✓�l 04 .e2/43 • 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 Tot No. of Ranges No.of Air Cond. Tons No.of Alerting Devices 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❑ Municipalnnection 0 Other Co No.of Dryers Heating Appliances KW 3e urity Systems:* No.of Devices or Equivalent No.of Water No.of No.of KW Heaters Data Wiring: 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: p 1304, (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: 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 coverap 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 th pains and penalties of perju ,that the information on this ap lication is true and complete. FIRM NAME: .I V I f �)\Ocf z I„fey (.. LIC.NO.: Licensee:U( Cc 2_ . Sr^f1ia Signaturei&_ 0 �� LIC.NO.: (Ifapplicab/ nt r 'ex pt"in the license number line.) Bus.Tel.No.. ( �1 �J Address: �(J (nheV S[ *k IA S t OS Uk 0�` .4\ Alt.Tel.No.: 3 &.) _ V '4 1 *Per M.G.L.c. 147,s.57-61,security work requires Department of Public fety"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, [hereby waive this requirement. I am the(check one)0 owner 0 owner's agent.Owner/AgentI Signature Telephone No. I PERMIT FEE:$