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Home My WebLink AboutBLDE-23-003998 Official Use Only /___ I` `� Commonwealth of Permit No. BLDE-23-003998 ..� o::: Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked Rev.1/07 APPLICATION FOR PERMIT TO PERFORM ELECTRICIAo WORK All work to be performed in accordance with the MassachusettsElectrical 1l Code (M Date: (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) To the Inspector o/Wires: City or Town of: YARMOUTH By this application the undersigned gives notice of is orher intention to per orm t e e ectnca work described below. Location(Street&Number) 39 MARINERS LN Telephone No. Owner or Tenant PATRICIA McCHLINS KI 1` Owner's Address 39 MARINERS LN,YARMOUTH PORT, MA 02675 1231 Yes 0 No 0 (Check Ap ropriate Box) Is this permit in conjunction with a building permit? Utility Authorization No. 2)� � t Purpose of Building Undgrd 0 o.of Meters Existing Service 100 Amps Volts Overhead ❑ g No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd ❑ Number of Feeders and AmpacitY Location and Nature of Proposed Electrical Work: Service u rade&minis lit s stem. Completion of the following table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.Susp.(Paddle)Fans Tran f,rm•rs KVA Generators KVA No.of Hot Tubs No.of Luminaire Outlets In- ❑ No.of Emergency Lighting •Above ❑ .rnd. Batter of nit Swimming Pool rnd. No.of Luminaires - No.of Oil Burners FIRE ALARMS No.of Zones No.of Receptacle Outlets D No.of Detection and No.of Switches No.of Gas Burners No.Init aD•vie•s Total No.of Alerting Devices No.of Ranges No.of Air Cond. 3 Ton Number T� KW No.of Self-Contained Heat Pump -Detecti'n Alertin' D•vice No.of Waste Disposers Total : Local CIMunicipal 0 Other: Space/Area Heating KW onne tion No.of Dishwashers Security Systems:* Heating Appliances KW SNo.ec riDevice or E i uival•nt No.of Dryers No.of No.of Ballasts Data Wiring: No.ot• Water KW No.of Devices ir E s uival•nt No.Hydromassage Bathtubs No.of Motors Tel if • or Si�ns Telecommunications Wiring: H•at r Total HP1 ival•nt OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. (When required by municipal policy.) Estimated Value of Electrical Work: 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 r the performance erfri al nce of equiv electrical undersigned yissue certifies unless the each coverage censee rides proof of liability insurance including"completed operation"coverage is in force,and has exhibited proof of same to the permit issuing office. S ecif CHECK ONE:INSURANCE 0 BOND El OTHER El ( p y:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ANDREW G THOMAS LIC.NO.: 22152 Signature Licensee: ANDREW G THOMAS Bus.Tel.No.: ---------- Address:dres:7applicable,enterCH "exempt"in the licenseM number line.) Alt.Tel.No.: Address:7 ECHO LN,CHATHAM MA 02633 *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 od does not have❑the oliability insurance er's coverage en normally required by law.But my signature below,I hereby waive this requirement.I am the(check ) Owner/Agent PERMIT FEE: $75.00 Telephone No. Signature &4'&alk2- 4( '7173 at,-,icun.,,c, smt -34?-8 73e .-),u- C..omnumwea/t h o/Kmacktoetti Official Usee 0e "'"� Jw �' ° s l 2 epartmert o/Jiro Se rvicee Permit No. � ,3 � °=_ Occupancy and Fee Checked fx �•` 71, ` BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/07 %Ai (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: 3`t A. 19 0.13 City or Town of: Yotihau ON 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) 39 in A ti i t(s (A 4 C q Owner or Tenant Pat.ifi(,k Ac c k t t a Sk4 Telephone No. 77LI` aril-q, Owner's Address 3 9 Al°tt'a C f S I °t rt Is this permit in conjunction with a building permit? Yes ❑ No g (Check Appropriate Box) Purpose of Building (eSt4t441 A t Utility Authorization No. Existing Service lG b Amps too / aa4 C Volts Overhead ❑ Undgrd 12ZI No.of Meters t New Service 200 Amps VI /ago Volts Overhead❑ Undgrd Z No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: .'20o Aim( Sc n(I ct, V r c,(a 4 t f /N e) sill -3 zoii 1nS4all Completion of the followingtai 1e may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-SusTf Total P (Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In- No.of Emergency Lighting No.of Luminaires Swimming Pool grnd. ❑ grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones oNo.of Switches No.of Gas Burners No. Initiating and on Devices Tot No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained P Totals: I k Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local El Municipal ❑ Other P Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP TelecommunicationsNofDevices or Y g No.of Devices Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of W ires. Estimated Value of Electrical Work: Si obb (When required by municipal policy.) Work to Start: ,a A 11/1(2)3 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 al BOND El OTHER ❑ (Specify:) I certify,under the painf and penalties of perjury,that the information on this application is true and complete. A FIRM NAME: T o�as ecoir.c.41 5t hill Tn(, LIC.NO.: o�.�if 1-/`I' Licensee: An►c)fsw lt1J(tdiS Signature C/4 --- 1/1/*--- LIC.NO.: (If applicable,enter "exempt"in the license member line.) Bus.Tel.No.: 6s(7' SIC-Sr), Address: 7 E.(.h o t An L. ( A I LiAt1 ciA o ,Y'1 Alt.Tel.No.: *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 Signature Telephone No. PERMIT FEE: $