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HomeMy WebLinkAboutBlde-19-003703 q\-A Commonwealth of Official Use Only or 2-4.101 Massachusetts Pennit No. BLDE-19-003703 , 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:12/19/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical work described below. Location(Street&Number) 29 CREST CIR Owner or Tenant COFFEY DENNIS P Telephone No. Owner's Address 155 BUTMAN RD, LOWELL, MA 01852-3042 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps 120/24( Volts Overhead 0 Undgrd ❑ No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: (1)new 120/240volt 200amp underground service utilizing existing underground conduit 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 15 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatine Devices No.of Ranges No.of Air Cond. 1 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 ❑ 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 Siens 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: 12/31/2018 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. pp v s CHECK ONE:INSURANCE 0 BOND 0 OTHER 0 (Specify:) �t7 I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Matthew P Glynn Licensee: Matthew P Glynn Signature LIC.NO.: 14492 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 11 RESNIK RD,STE 1,PLYMOUTH MA 023607231 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 J (/i V7©•z/ C' lV_ C/'/ -, -= (1%'''cr 6/ e G t -3 evuourr 2 t. 5(4� to .0( . i(t/A- h9 ice eiz.u4 o S 508-694-6884 3 Diamonds Path, Unit 2 My enerc onErergy2 (1 Ore cl-,-- S. Dennis, MA 02660 /"/ /f414%L '40 // . 5/30Iq 'rep 1-vel = /3, /6 5 sx ?4di ------ -- f) , , A... . 4.0c9ifia-- . ..-- 1I*, I ..�;�,,ems 1 s-, °° RONALD v., o JAMES c_i (' CADILLAC V,i #35779 , *04 °FFs s�0`�4. qNP S U_I.?, / q o : l j 6-Lev r -/UA�/t 'B_______\___,,.......„ de"? I if j hj' 1,0410 2 . il 1)4S wil 61 ..! i -.9.er• -1-,..- jite7 / h01 `'‘ / D ' i. / t � r '''',1 -4 bt, 1 f Ai4 if - - ish ,2, —j 2 6 /00 ...,,, 9,