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Home My WebLink AboutBLDE-21-005962 tk-1/� Commonwealth of Official Use only E` 11 Massachusetts Permit No. BLDE-21-005962 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•4/15/2021 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) 17 MOSS RD Owner or Tenant J.Kennedy Telephone No. Owner's Address 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 ❑ 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: Replace service&panel. 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 ❑ Municipal Connection 0 Other: No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of 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: 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 J Peckham Licensee: Daniel J Peckham Signature LIC.NO.: 26830 (If applicable,enter"exempt"in die license number line.) Bus.Tel.No.: Address:87 AUDREYS LN, MARSTONS MLS MA 026481629 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 I 0471.-1116-6 Uc)( Lt(v(Z 14 Commonwealth ol Maaeaclhuhestto Official use Only_ / �J v 11 -z 2,,,,a...14.. 4.services Permit No. �� -��O t/ ?;- _4 Occupancy and Fee Checked ,,. BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07) I` - (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC).527 CMR 12.00 1 li (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / i, 3/ 1 Cityor Town of: �!,✓t�y,.t�: To the Ins ector f Wires: CI By this application the undersigned gives notice of is or her intention to perform the electrical work described below. ti Location(Street&Number) / 1 aryl B.,.s. Owner or Tenant 1 . 4.( �a,,a Telephone No. Owner's Address Q) Is this permit in conjunction with a building permit? Yes ❑ No,\ (Check Appropriate Box) Purpose of Building Utility Authorization No. tit Existing Service Amps / Volts Overhead 0 Undgrd 0 No.of Meters 11 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity -k Location and Nature of Proposed Electrical Work: ifk..e.r C.e4A__< S Y.2. it t c_-r -t, ?Gryt„t_( Completion of the followingtable may be waived by the Invector of Wires. No.of Recessed Luminaires No.of Cell.-Snap.(Paddle)Fans Tr of K Transformers KVAVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Swimming Pool and. ❑ In- ❑ No.of Emergency Lighting grad. ant 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. To l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW 'No.of Self-Contained Totals: !Tons_ _. .____.. Detection/Ale Devices No.of Dishwashers Space/Area Heating KW Local❑ Mun� Connection ❑ ` No.of Dryers Heating Appliances Ky4, Security * No.of Water , No.of No.of Data No.of or Equivalent - 1ti Haters Signs Ballasts Na of Devices or ulvaient No.Hydromassage Bathtubs No.of Motors Total HP 'relecommunicationsE j No.of Devices or Bo"uiv in _ v OTHER: V Attach additional detail if desired or as required by the Inspector of Wires. 13 Estimated Value of Electrical Work: (When required by municipal policy.) ''...) i Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. i .) 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. C CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cerdfy,under the pains and penalties ofperjuy,that the information on this application is true and complete FIRM Nam: LKC.NO.: Lkensee:T lh e J -5. f, _e_ktiG,,i. Signature / LIC.NO.4A 4 ' yj Of applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: ..e Z.1.. ivZ41.S 7'n,� 64: (is yn� ./92Lf<2Xlt.TeL No.:�aR=T7L 43.' 5 *Per M.G.L.c. 14 ,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)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$