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Home My WebLink AboutBlde-19-003279 ` �`� ; Commonwealth of Official Use Only • E ` Massachusetts Permit No. BLDE-19-003279 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:11/29/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives no ice o is or her men ion o pe orm c ica work des .bec(below. Location(Street&Number) 148 PINE GROVE RD II Owner or Tenant REYNOLDS VIOLET A(LIFE EST) Telephone No. Owner's Address 22 UTICA DR,WORCESTER, MA 01603 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: Master bedroom&bath addition. Septic system upgrade. 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- ElNo.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 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 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 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: DANIEL 0 WILKEY Licensee: Daniel 0 Wilkey Signature LIC.NO.: 32288 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 168 CENTER ST, SOUTH DENNIS MA 026603744 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 t,4 31C4441.., , (No U' �ivs� ''` - `77 ? IOileci ilfr 4. ti C 61 ig,h E3 ,t' .2 �A 3(st (ci I 0. -: -- Commonwealth of///newt t7;! Official Use Only _* +{__ c� Serviced iE 19 J 3 �z 79 _ r1 IT = eparfineni el._tire J Permit No. ervices REGULATIONS Occupancy and Fee Checked BOARD OF FIRE PREVENTION R [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: 4,10✓ t98 / ' City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndersigned gives notic of his or her intention to pe the electrical work described below. Location (Street&Number) Ng sl n I rr'oV 8, • .), Armno N1 (p Owner or Tenant My *,_v 1-� ` / Telephone No. Owner's Address 7/ TOO n FAT < ,5Ai ii Al. I-I • I this permit in conjunction with a buildingL = "J P Yes No ❑ (Check Appropriate Box) �\ ' Purpose of Building O 1- 1' 'PAT I 1 r, Utility Authorization No. � Y Existing Service Amps / Volts "Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No,of Meters Number of Feeders and Ampacity t.oeation and Nature of Proposed Electrical Wo,r�• g <:) ',c, 5 y6 i " M► 54-1'- -g torDN ��1 + raa t 1 di- 1a 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. ^rnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number!Tons I KW No.of Self-Contained -i Totals: f Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other ` No.of Dryers Heating Appliances Kt Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of 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: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule I0,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 BOND 0 OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: Licensee: � Signatur (If applicable,enter"exempt"in the license tuber line.) / . LTC.NO.• �-. . Address. Bus.Tel.No.: ....*, J *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance covernally n— o - S required by law. By my signature below,I hereby waive this requirement. I am the(check one 0 owner o Owner/Agent ❑owner's a ent Signature 0.1 Telephone No. PERMIT FEE: $