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Home My WebLink AboutBlde-20-002625 \` Commonwealth of Official Use Only atiA Massachusetts Permit No. BLDE-20-002625 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:11/5/2019 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) 28 HEDGE ROW Owner or Tenant CARR ROBERT E TR Telephone No. Owner's Address 28 HEDGE ROW REAL ESTATE TRUST,22 CAHILL PARK DR, FRAMINGHAM, MA 01702-6135 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: Meeting to discuss violations. 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 Initiatine 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 ❑ 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: Timothy A Willman Licensee: Timothy A Willman Signature LIC.NO.: 17476 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:53 STURGIS LN, BARNSTABLE MA 026301419 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 144_ (i((If iC n < < �g it 9 ! . FCE ' VED UJ ' cer 1 ,o, 0,.1■C- 2n19 Cornnsonwaa&o f Maadachueatfe Officialy Use Only L r 1 .1 `+ m t N T Permit No. `" 2-fJ Z ZS' B l _1n sparfmsni oi 5ire SPviced ' I irk ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I t 6 1cl, City or Town of: YARMOUTH To the Inspe or Wires: By this application the undersigned gives notice f his or her inte on to perform the electrical work described below. b ) G. Location(Street&N , tt L Owner or Tenant Clef./ ,\ Telephone No. Owner's Address 1ID'( t Is this permit in conju�with abuilding permit? Yes ❑ No 0�(Check Appropriate Box) Purpose of Building SIVL Utility Authorization No. Existing Service Zilt, Amps (p/ Zolts Overhead e' Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity _ Lo o and to a of Propo Electrical Work: 'Z U V$\ V _ ge— ak '3 Completion of the following table may be waived by the Inspector of Wires. Total 11. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No f Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above r—i 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 AlertingDevices Tons No.of Waste Disposers Heat Pump Number Tons KW -No.of Self-Contained Totals: Detention/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ 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 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: 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: INSU' • CE krBOND ❑ OTHER ❑ (Specify:) I certify,under the p• and pen, 'e erjury tHhe information on this application is true and complete FIRM N• k_ = l LIC.NO.: Licensee:ek/& _ , Si nature LIC.NO.: t y c Of applicablestexe "in th= icense umber line.) us.Tel.No.• ,� l � _ Address: Alt.Tel.No.: ,s *Per M.G.L.c. 147,s.57-61, curity work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE W IVER: 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 Signature Telephone No. PERMIT FEE:$ v se, V sj4