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BLDE-21-002712/ `L\�or- Commonwealth0 of Massachusetts Official Use Only Permit No. BLDE-21-002712 �:. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/071 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:11/12/2020 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) 243 WOOD RD Owner or Tenant LANG DONALD H TRS Telephone No. O / Owner's Address LANG ELINOR M,243 WOOD RD, SOUTH YARMOUTH, MA 02664-4253 a Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A 'i. i B i + Q /1 Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of s0 New Service Amps Volts Overhead 0 Undgrd 0 No.of Mete s Number of Feeders and Ampacity 4.??Location and Nature of Proposed Electrical Work: Repairs of grounds&upgrade service drop&meter socket. VVV Completion of the following table may be waived by the Ins • 4 Wires. No.of Recessed Luminaires No.of Ceil: No.of Tota Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In-d. ❑ No.of Emergency Lighting grnd. grnBattery 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 Space/Area HeatingLocal ❑ Municipal No.of Dishwashers P KW Connection ❑ Other : HeatingAppliances No.of Dryers PP 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 Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP 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 perjuty,that the information on this application is true and complete. FIRM NAME: WILLIAM C FLIGG LIC.NO.: 12584 Licensee: William C Fligg Signature (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:55 FREEMAN RD,YARMOUTH PORT MA 026752304 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 'PERMIT FEE: $50.00 Signature Telephone No. B, �j Official Use1Only l t�o�rtnwnweaGth o�//laaeac�iciestla permit No. UCS �� l department o/.�ire&races _% ,n•, Occupancy and Fee Checked t( BOARD OF FIRE PREVENTION REGULATIONS [Rev, 1/07] (leave blank) -.-n1 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 3PE ALL INFORMATION) Date: \L-\ -Zv City or Town of: CJ�it/n6::�� To the Inspector of Wires: By this application the undersigned gives notice of is or her intention to perform t e electrical work described below. Location(Street&Number) ,,:2 CI 3 W©G aCO kGv-wvoL � v\AAv°t- Owner or Tenant NQ`\ Telephone No.54'77(0(IZALI Owner's Address Is this permit in conjunction with a building permit? Yes I I No Fr (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service %uV Amps Vt.() /2`((t Volts Overhead t_'Undgrd n No.of Meters New Service Amps / Volts Overhead P Undgrd n No. of Meters Number of Feeders and Ampacity `` Location and ature of Proposed Electrical Work: •\e 'I _� v'\CSL .,,,• \A .. L-0-- C \CACI S — rrt( 4tr kA-5 ,"Deck\►6-ti S%L-. Comp Mon o followin table may be wed by the Inspector of Wires. No,of Total No.of Recessed Luminaires No.of CeiL-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.01 Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grad. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners Na,of Detection andInitiating Devices Total No.of AlertingDevices Na. of Ranges No..of Air Cond. Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipalr---1❑ Other * No.of Dryers Heating Appliances KW Sec ri of Systee<ic s:or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent Telecommunications irtngg No.Hydromassage Bathtubs No.of Motors Total IIP 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:\A-145-1,---0 t Inspections 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 ErBOND 0 OTHER 0 (Specify) I certi r,under the pains and penalties of erjury,that the information on this application is true and complete. FIRM NAME: V.)clk(_.a:wti C `-1,. S. C.1 e L � ( LIC.NO.: t ZS S--(--(-1--) Cr i Signature �.(t/ LIC.NO.: (Licensee:f pp Bus.LW.N.:77 Y S V7-/3`i 1 applicable,enter"exempt"in the licet rnber line.,) Alt.Tel.No.: Address: *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. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner 0 owner's agent. I e Owner/Agent Telephone No. I PERMIT FEE: $ Signature Q