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HomeMy WebLinkAboutBuilding Permits BackfileAPPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, (MEC), 527 CMR 12.00 q;g n (OFFICE USE ONLY) _ TO N � ( OUT By � � d 'ram` J�2 °l1' Fee: $ nl S�1 MAR 1 5 2004 U rJ PERMIT NO. BUILDING DEPT (PLEASE PRINT IN INK O N) Date: 3 /S d L/ 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 & Owner or Tenant_ Is this permit in conjunction with a building permit? ❑ Yes NNo (Check Appropriate Box) Purpose of Building Sc—:7,/ / v Utility Authorization No. Existing ServiceQ Amps Volts Overhead Undgrd ❑ No. of Meters New Service -/Z)a Amps /20 / 2 qb Volts Overhead Undgrd ❑ No. of Meters Number of Feeders and Location and Nature of Proposed electrical Work: .py/7/% rA N r) p`'L PTc✓- >C6 ✓' L7 ✓ ,/y& / ()KC t Completion of the followin¢ table may be waivedby the fnspecmr ofWi es No. of Total No. of Recessed Fixtures No. of Ceil.-Sus . Paddle Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA Above n- ❑ ❑ No. of Emergency Lighting No. of Lighting Fixtures SwimmingPool tad. tad. Battery Units No. of Receptacle Outlets No. of Oil Barriers FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. o ewcnon an Initiatin Devices 61 Total No. of Ranges `i No. of Air Cond. Tons No. of Alerting Devices Heat Pu tap um er ons K No. of Self -Contained No. of Waste Disposers G Totals: — — — — Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Municipal Local ❑ Connection ❑ Other No. of Dryers rY Heating Appliances KW g pP Secutity Systems: No. of Devices or Equitivalent 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 Teleco cations Wiring: Y g No. t is or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may be issued 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. kljCHECKONE: INSURANCE BOND❑ OTHER❑ (Specify:) U Estimated Value of Electrical Work: .SG7�7 (Expiration Date) (When required by municipal policy.) ,,� Work to Start:S I`fn ,, Inspections to be requested in accordance with MEC Rule 10, and upon completion. a ki an I certify, under the pains d penalties of perjury, that the information on this application is true and complete. FIRM NAME: / v/7- !;�'— 2-C G✓ 1-1619 / LIC. NO. 3.3 L 70 h Licensee: Gam+ uCt. Signature C LIC. NO. s,s /� %L5 F (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.:.3 Z. 0 Address, C% Z ///� �'Cc�.:/,T _ ��t Ko [/.0 Alt. Tel. No.. 3 9 c( E.-©.� OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature elow, I hereby waive this requirement. I am the (check one) owner owner's agent. Owner/Agent Signature Telephone No. [Rev. 04/001 of p TOWN OF YARMOUTH Building Department BUILDING �?+ � (508) 398-2 ex 26 PERMIT NO •- B-04296 - - PERMIT ISSUE DATE 9/5/03_ PROPOSED U IE APPLICANT (Williann cMaho_n JOB WEATHER CARD _ _ _ PERMIT TO Repair \ AT (LOCATION) 100151BAYVIEWST ZONING DISTRIC R-25 Bldg. Type: Resitlential SUBDIVISION MAP LOT BLOC 028.29 BUILDING IS TO BE: CONST TYPE 5-B USE GROUP R-4 LOT SIZE CONTRACTOR strip and reroof, paper and vent to code ( 30 Arlington Street) LICENSE 0 REMARK AREA (SO FT) EST COST ($ $9,000.00 PERMIT FEE ($) $50.00 OWNER IWILLIAM J MCMARON BUILDING DEPT BY ADDRESS 139 Chestnut Street Seekonk I MA 102771 INSPECTION RECORD FIELD COPY Se,e Cek0 —