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Home My WebLink AboutBlde-20-000098 or- Commonwealth of Official Use Only Permit No. BLDE-20-000098 L. Massachusetts 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:7/9/2019 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) 14 SOUTH RD Owner or Tenant HENDERSON JANICE R Telephone No. Owner's Address 14 SOUTH RD,WEST YARMOUTH, MA 02673 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: Wiring for sitting room&bath. 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 Inrtiatine 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 ❑ 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: PETER C FRUEAN Licensee: Peter C Fruean Signature LIC.NO.: 27553 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 137 PRINCE HINCKLEY RD, CENTERVILLE MA 026322149 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) ❑ owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 Lot ct -(NS.(9 v II( I 3(/ g ) ecuatt- klefi 9 Et_i k eg'r. lam ' i,v R� 1_Ait c) l,ommonweatt'lls oil i i/a aeh StfJ Official Use Only ilk_ aparfinanf of,lira Services Permit No. (�'rLJ1O/ BOARD OF FIRE PREVENTION REGULATIONS O` an`y and Fee Checked (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: 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) () • Owner or Tenant 4 014 Telephone No. Owner's Address 541/4C Is this permit in conjunction with a building permit? Yes e No 0 (Check Appropriate Box) Purpose of Building ins"f`t't Qt Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und d gr ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ 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.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 Lmergency Lightmg - Enid. grnd. Battery Units No.of Receptacle Outlets No.of OilBurners FIRE ALARMS JNo.of Zones , No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. TotalTo No.of Alerting Devices No.of Waste Disposers Heat Pump I Number'Tons KW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal - Connection ❑ Other No.of Dryers Heating Appliances KW ecNo Systems:* No.of Water No.of No.of Devices or Equivalent Heaters ' No.of Data Wiring: - F Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work to Start: (When required by municipal policy.) INSURANCE COVERAGE: Unless waived by the owner, permit pections to be requested in dfor the performance of ce with MEC Rule electric uponl work may issue unl compaction. the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Th ess undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing office. e CHECK ONE: INSURANCE BOND ❑ OTHER I certzfy, under the pa' and en f perjury,s o that (Specify:) FIRM NAME: information on this application is true and complete. Licensee: LIC.NO.: Signature (If applicable.enter"erem t" the license Nimber lin .) LIC.NO.:� . Address. :y� efix t Bus.Tel.No.: J `Per M.G.L. c. 147,s.57-61,security work requires Alt.Tel.No.: ;s- OWNER'S INSURANCEepartrnent of Public Safety"S"License: Lic.No. by law. WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— o ma(� S Owner/ ed Agent By my signature below,I hereby waive this requirement. I am the(check one ❑ Signatureowner El owner's a:ent Telephone No. PERMIT FEE: $