HomeMy WebLinkAboutBLDE-20-004719 1
co Commonwealth of Official Use Only
E`. Massachusetts ' Permit No. BLDE-20-004719
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
APPLICATION FOR PERMIT TO PERFORM EL CTRIC L WORK; `
All work to be performed in accordance with the Massachusetts Elect' al Code I EC),527 CMR I 00 4
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4': 020 MAR -2 2020 i
City or Town of: YARMOUTH Toth: ns.. or of Wires:
By this application the undersigned gives notice of his or her Intention to perform the electrical work de ibed below. -• y_,_
l.;(...;,Li)i c, L,p I.
Location(Street&Number) 25 PEREGRINE LN t3y
Owner or Tenant Paula&Greg Nelson Telephone No. _.
Owner's Address MA
Is this permit in conjunction with a building permit? Yes 0 No ■ . opriate Box)
Purpose of Building Utility Author' i it o IA A
—
Existing Service 100 Amps 240 Volts Overhead 0 Undgr i ii gi f M
New Service Amps Volts Overhead 0 Undgrd 0 of e
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: This property is under new ownership
Paula and Greg Nelson De
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 16 No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformer‘52) KVA
No.of Luminaire Outlets 4 No.of Hot Tubs Genera , KVA
No.:: :::::sOutlets
Swimming Pool Above ❑ In ❑ ' iiiii°47
nd.No. 16 No.of Oil Burners FIRE ALA 0
No.of Switches 10 No.of Gas Burners No.of Detection and
Imhattng Devices
No.of Ranges No.of Air Cond. Tons Total No.of Alerting Devices 7
No.of Waste Disposers 1 Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices 2172:10
No.of Dishwashers 1 Space/Area Heating KW Local ❑ Municipal 0 Other.
Connection
No.of Dryers 1 Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring: 3
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: 02/26/2020 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
Aides 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: BARRY T SWAIN
.,Licensee: Barry T Swain Signature LIC.NO.: 33983
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:248 OLD COUNTRY WAY, BRAINTREE MA 021848334 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
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