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Home My WebLink AboutE-08-257Commonwealth of Massachusetts 0fficial use Only i Q� t .,4e Department of Fire Services Permit No. C� 2 BOARD OF FIRE PREVENTION Occupancy and Fee Checked 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 (NIEC). 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: rv�Vp By this application the undersigned gives notice of his or her intention to perforin the electrical work described below. Location (Street & Number 29 Nightingale Drive, South Yarmouth Iti Owner or Tenant Joseph Hayes Telephone No. 508-394-3672 \ Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No +® (Check Appropriate Box) Purpose of Building Residential Utility Authorization Na 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 ofthe following table may be waved by Ike Inspeclor of IfIres. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Ilot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ !n- ❑ red rod a o ergencY Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS Na of Zona No. of switches No. of Gas Burners o. of Detection and Initiating Devices Na of Ranges Na of Air Coad Tons Na of Alerting Devices No. of Waste Disposers Heat Pmmp Totals: Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection Na of Dryers lieating Appliances KW Security Systems: Na of Devices or Equivalent No. of Water KW Heaters No. of No. of Si as Ballasts Data Wiring: No. of Devices or Equivalent Na Hydromassage Bathtubs No. of Motors Total IIP Te aommumcatioms Wiring: Na Devices vices or Equivalent OTHER: Attach additional detail !f desired, or as required by the Inspector of If7res. OEstimated Value ofElectrical Work- (When required by municipal policy.) Work to Start: Will call when ready laspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE. UnlZis 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 (/ I owify, under ike pairs and penakies of p Vug4 rkar rhe Iryarnmtion on rets yppUcaaan is tragi and aarr#ilefe. (Expiation Date) FIRM NAME C.NO.: A17137 w Licensee: Edward L Merry Signature fl±UaI14 LIC. NO.: 35745E (eapplicable, enter "exempt" in the lkerue number line.) Bw. TeL No:: 508.394-7779 Address: 8 REARDON CIRCLE SOUTH YARMOUTH MA 02664 Ale. Td. No *Security System Contractor License uired for this work if applicable,enter the license number here: OWNER'S INSURANCE WAIVE E. I am aware that the not the i9' taattco poverage iroririally required by law. By my signature below, I hereby waive this requirement. I tun the (quack one) ❑ owner • ❑ owner's aRbnL Owner/Agent PERMIT FEE. $ Signature Telephone No. �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. $