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Home My WebLink AboutBlde-20-002928 Official Use Only Commonwealth of ' E Massachusetts Permit No. BLDE-20-002928 *,1BOARD 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:11/19/2019 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) 5 JONES RD Owner or Tenant WOOD JOANNE D Telephone No. Owner's Address 5 JONES RD, SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes ❑ 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: Septic pump&alarm. 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 1 Totals: Detection/Alertine 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 Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors 1 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: DAVID R NICOLL Licensee: David R Nicoll Signature LIC.NO.: 37557 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 144 DRIFTWOOD LN, S YARMOUTH MA 026641038 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: $50.00 6.14 «f 2069 i • �/ Official Use On1y .'+�\ (...om.m.onwealth o////c.sjachaaatf* �' 0 '� e\\ ryry,, _ Permit No. C�'l Chu *tt �1 ..2 eparin�.ent n/Jtrc .ervices r w 1 i_ Occupancy and Fee Checked ir �1' BOARD OF FIRE PREVENTION REGULATIONS y,1� �, [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC 527 CM 12.00 C; (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Ai C V. 1 e l/ City or Town of: X AZ tVlk t) 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) `TO fJ tS g b "' Owner or Tenant ��L `�N `\J Telephone No:#b-7 it±i 0,- Owner's Address �I Is this permit in conjunction with a building permit? Yes ❑ No� (Check Appropriate Boz) 9 Q4 i Purpose of Building Utilityy Authorization No. Existing Service /"A" Amps Icy c /0i/e" Volts Overhead Ir Undgrd ❑ 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: Completion of the following table may be waived by the Inspector of Wires. No. Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVAfarmers V A No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above in- No.of Emergency Lighting No.of Luminaires Swimming Pool gmd. ❑ 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. Ton Total 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 0 Municipal ❑ Other Connection No.of Dryers Heating Appliances liances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP Telecommunications Wiring: y g _ 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 Stan: 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 e :'ted proof of same to the a 't i.suing office. CHECK ONE: INSURANCE 51 BOND 0 OTHE: ■ (S•eci :) 1 certify, under the�ins and penalties of perjury,that the inf. s tion on i•applica '.n '. •ue and cow ete. FIRM NAME: !l ON i D Ni it:o 1 L / LIC.NO.: '3 1 557 E Licensee: Si. , Al LIC.NO.: (If applicable, enter"exempt"in the license neumber line.) - Bus.Tel.No.: SQ 39q"b4 31 'i N Address: 14 U Ft woO.h 01 - . Y a)tik O WI Alt.Tel.No.: 5..0 -3bo-`1M3 Cc u *Per M.G.L. c. 147,s 57-61,security work requires Department of Public Safety"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,I hereby waive this requirement. I am the(check one) 0 owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ 1 Ci renatnra. To1vnhnna Nn