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Home My WebLink AboutBlde-20-002557 o. ` Official Use Only € Commonwealth of Massachusetts Permit No. BLDE-20-002557 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:11/1/2019 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) 39&39A MONOMOY RD Owner or Tenant KANE JOHN E Telephone No. Owner's Address KANE SANDRA M,39 MONOMOY RD,SOUTH YARMOUTH, MA 02664 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: Replacement furnace(Garage) 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 1 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/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 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 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 tc_ ROO -t+ 37 a.'"7 14 l..ommonaea&o/t'/Iaadachuaslto Official Use Only't cc�� n Permit No. �'��-' 2 91y l 4:-— r 2sparlm cc��anl of ire Serviced 1 i 7.1 Occupancy and Fee Checked 53 ad "� ...or [Rev.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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: /// f1/4'1 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) 3 ii /fl0170 V?o y eat • Owner or Tenant To CV k.OL ytt. Telephone No. 5-6 Y'6,rS-S6 s`6 Owner's Address 3 M 00 d VrOt/ Ce ` 5`yorinv Is this permit in conjunction with a building permit? Yes ❑ No Egi (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: par et y t ( •r U r yi a Ce, rep(ace me n It ) • 's- Completion of the following table may be waived by the Inspector of Wires. Total '�c No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Tf Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA 4 No.of Luminaires SwimmingAbove In- No.of Emergency Lighting Pool 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: 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 o ater No.of No.of KW Data Wiring: i Heaters Signs Ballasts No.of Devices or Equivalent _ 10 Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. �, No.of Devices or Equivalent I ' N 1 R: I !n. Attach additional detail if desired,or as required by the Inspector of Wires. Ij, ,- , ti ted Value of Electrical Work: /QQ,0 (When required by municipal policy.) ? } or to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. ! 45S RANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless I It LU hi li ensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The igned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. 1_ __. - .eK ONE: INSURANCE ❑ 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: Tgdk tea VIC h Orn e a w y►t r . LIC.NO.: Licensee: Signature LIC.NO.: (If applicable.enter"exempt"in the license nAmber line.) Bus.Tel.No.• Address: 3 9 and no foL (Cd . S•yZ t/'h't Alt.Tel.No.: *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. y my signature below,I hereby waive this requirement. I am the(check one)®owner 0 owner's agent. Owner/Agent Signature , c-,ma Telephone No.5 4?5 - PERMIT FEE:$ 5656