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Home My WebLink AboutE-08-257�C-\ Commonwealth of Massachusetts Official Use Onlysomisom Q Department of Fire Services Permit No. ' 8, 267 BOARD OF FIRE PREVENTION Occupancy and Fee Checked (p �� ` REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NffiC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/20/2007 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 29 Nightingale Drive, South Yarmouth t� Owner or Tenant Joseph Hayes Telephone Na 50&394-3672 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No *® (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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: Electrical for furnace replacement Completion of thefollowing table may be waived by the Inspector of lyres. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Na of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ o. of Emergency Lighting rnd. grnd. B!= Units Na of Receptacle Outlets No. of OR Burners FIRE ALARMS Na of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Coad. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons JKW Na of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating DSV Local Cl Munieilial ❑ Other connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivaknt No. of Water KW No. of No. of Data Wiring. Heaters Signs Ballasts Na of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications W'nbg: No. of Devices or Equivalent OTHER: Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Werk to Start: Will call when ready 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 pro- vides 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 ® BOND ❑ OTHER ❑ (Specify.) GENERAL COMP. LIABILITY 12/01/2007 (Expiration Date) certify, under Me pains andpamkaw of perjury,11W Me infarAwbon on this appiicadan is trswe and FIRM NAME: C. No.: A17137 Licensee: Edward L M= Signature fZ41. LIG No.: 35745E (If applicable, enter "exempt" in the license number line.) Bus. Tel. Na: 508-324-7778 Address: $ REARDON CIRCLE SOUTH YARMOUTH. MA 02664 Alt. Tel. N;.:` OWNER'S INS CE W • I am aware that the Licensee does not have the nY Inst a ,poverap normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's a&bat. Owner/Agent Signature Telephone Na PERMIT FEE. $ .0 JUL IL By -`t Coavnonwaa& 0/ l mac"Mj Apar&wnt o/-7im S Siwe OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. E —O F' 01?/ Occupancy and Fee Checked [Rev. 1/071 leave blank) ATION FOR PERMIT TO PERFORM ELECTRICAL WORK G ll work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 L�ASEPBIIY IN INK OR TYPE ALL INFORAM ION) Date: �7-- �.5� —0 7 City or Town of: To the Inspector of Wires: By this application the undersign gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) hG h L 7-7 0; (!Z 1 IC et t - Owner or Tenant QeC_e eA S 100, U Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building 'ufJP y No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ 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: �F2-l11rs�Y �Jyl�it� e r/o//1 r lAIALSo c'.- lii I � r �,. ) .r,vi,.�H -- Tr iL-7-tV —'7Z -,-- r/ Com letion o the ollowin table maybe waived bX the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans o, of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires ove M in -0o. Swimming Pool rnd. rnd. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiatin Devices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers eat Pump Totals: ,,.,, nm,. er ons '- o, oSelf-Contained Detection/Alertine Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal❑ Other, Cyyonnection No. of Dryers Heating Appliances KW ri No. f Devices or Equivalent. No. of Water KW o. o o. o Data Wiring: Heaters Signs Ballasts No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP el ecommunications tiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. ated Value of Electrical Work: �� (When required by municipal policy.) Work to Start: Z�-07 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] BOND ❑ OTHER ❑ (Specify:) I certify, under the pains nd penaltie of erjury, that the information this is true and complete. FIRM NAM 0 1 E� LIC. NO.: Licenseec�Ci(l2ytj St) 1) )U� Signatu LIC. NO.: �(If applicable, »ter "exempt" in the licelM numb line.) /' Bus. Tel. No.: Address: e6E 4P , Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lie. 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $