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Home My WebLink AboutBLDE-21-006096 Commonwealth of Official Use Only tin No. BLDE-21-006096 € 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:4/22/2021 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice or his or her intention to perform the electrical work described below. Location(Street&Number) 7 HOLWORTHY PATH Owner or Tenant TRACHTENBERG DEBORAH Telephone No. Owner's Address 130 LYNNES WAY,TEWKSBURY, MA 01876 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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 ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Re-attach service following replacement siding installation. Completion of the following table maybe 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 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 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: David R Nicoll Licensee: David R Nicoll Signature LIC.NO.: 37557 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 144 DRIFTWOOD LN, S YARMOUTH MA 026641038 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 - Signaturez , aj n 1,T�elephone No. t d p PERMIT FEE: $50.00 G� �j /- Official Use Only � CnmmonuieatI of �Y/caiachuecii. /� 1 C0�� . Permit No. �'U =,=fi_ ' Ali — t 2eparlmenl n`��ire Sertace9 -=f-Z.' BOARD OF FIRE PREVENTION REGULATIONS Occupancy 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(MEQ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYP L INFORMATION) Date: AfR IL_ .t L � I City or Town of: Ap-MO0 — To the Inspector of Wires: By this application the undersigned gives noti e f his or her intention to pe rm the electrical work described below. Location (Street&Number) Q LW D 0-71k y cgOwner or Tenant Telephone`t`�' Telephone No. Owner's Address _,/ Is this permit in conjunction with a building permit? Yes ❑ No L1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 100 Amps l /D�y lQlolts Overhead e Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity { _ Location and Nature of Proposed Electrical Work: E. C` YC � } a E ) 5Zb tW-�'— Completion of the following table may be waived by the Inspector of Wires. No. al I No.of Recessed Luminaires No.of Ceil.-Susp. (Paddle)Fans Transformers of KTVA KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ g,� Battery UniNo.of ts Lighting 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 Disposers4. Heat Pump Number { Tons. KW No.of Self-Contained Ei Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection -4 - k. No.of Dryers Heating Appliances KW Security Systems:*No.of Devices or Equivalent No.of Water No. of No. of Data Wiring: I. Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP ITelecommunications Wiring: i No.of Devices or Equivalent �./ OTHER: LZ. 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 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the Iicensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent.The %,,J undersigned certifies that such coverage is in force,and has exhibited proof of same to the .ermit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ .ec .':) C�l c�l1'5 Ce 1 certify, under the pins and penalties of perjury,that the informatio on this a.. .'on is jind completf. FIRM NAME: I)A�v'i.) Ntcc Li— JJ�IC.NO.: .3'7 c 5 7 6L '1J. c Licensee: Signatu�,�. ,t�I_�' �IC.NO.: YC (If applicablei enter"exempt"in the license lumber line.) us.Tel.No.: 0 8 :>9L(`-bQ. I Address: Ili if bfLl Frvoe 1 L `�- .: t'� t A ' , _61 Alt.Tel.No.: 03.-.30`"13i3(«"C.1.) *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. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent j y f Signature Telephone No. ! PERMIT FEE.' $