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HomeMy WebLinkAboutE-18-6707 I 4.i Official Use Only Commonwealth of rES Massachusetts Permit No. BLDE-18-006707 � ,� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IRev.l/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:5/28/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her attention to perform the electrical work described below. Location(Street&Number) 221 WILLOW ST Owner or Tenant CTS FIDUCIARY LLC Telephone No. Owner's Address C/O MILL LANE MANAGEMENT INC,221 WILLOW ST,YARMOUTH PORT,MA 02675 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps - - Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity _ Location and Nature of Proposed Electrical Work: Wiring for new offices. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires I 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 ,ImtiatineDevrces No.of Ranges No.of Air Cond. Total I 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 0 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. © t, 333 1 p CHECK ONE:INSURANCE 0 BOND ❑ OTHER 0 (Specify:) GtR �-\ I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Christopher R Swift Licensee: Christopher R Swift Signature LIC.NO.: 37071 (if applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:8 PINE TER, E SANDWICH MA 025371432 Mt.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 Signature Telephone No. PERM FEE:$80.00 cd-Uati 6rn b eWeA ). .ri Commonmcat&J,.of/1/a66achadatt6 Oiveial Use tJal V -(...t.) -----qtit'- apartment t( �J Permit No. /L 070 7 s .LCDaryr{Cy,v{J�JervGcc6 :• 2-2 BOARD OF FIRE/ PREVENTION REGULATIONS Oce1107) and Fee Checked - �= In. 1/D77 peave blnk) APPLICATION FOR'PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachuse¢s Electrical Code(MEC),527 CMR 12.00 (PLEASEPRINTININKOR TYPE ALL INFORIL477QA9 Date: i City or Town of: YARMOUTHTo the Inspector of Wires: w .. By this application the pndersiged gives notice of his or bur intention to perform the electrical work des bed below. c Location(Street&Number) 22 � 08:376—Occor _ Owner or Tenant Ors g ,� Lc, e___ TelephoneNoc5 C 1 i k Owner's Address 2 3(' ti.)&&L,o L. K� 4 Per A LU . I Is this permit in conjunction with a building permit? Yes We No 0 (Check Appropriate Bot) Ct' It Purpose of Building /� r ^`i Utility Au hortrstion o. Existing Service 4a) Amps 4,0 / a-t) Volti Overhead 0UndgrdNo.of Meters _____- New Service //A Amps / Volts Overhead 0 Undgrd ❑ Na.of Meters Number of Feeders and 4mpac tp 3 / /1, J\ . LocatiroLLn and Nature of Proposed Electrical Work: ��'c`�- ,p'a 4Like r. a q .ea Completion of the fpfowinz table may be wmved by the Inspector of Wives, No.of Recessed Lnrirnires 'No. of Cel-hasp.(Paddle)Fans No.of Total ITraasformers KVA • No.of Luminaire Outlet 'No.of Hot Tubs (Generators • KVA ' — No.of Luminaires Swi.*+ni.,g Pool Above 0In- tan.:Int t cy L ar, • - errrd. e- d. U Mattern Units is Na. of Receptacle Outlets . 'No.of Oil Burners IFTRE ALARMS 'No.of Zones Na. of Switches 'No.of Gu Burners Haras No.of Detection and No.of Ranges Total Iaitiatine Devices INo. of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers - IHeatPump INnmber 'Tons [KW No.of Self-Contained Totals: to.of.on/Alettino Devices No.of Dishwashers ISpacelArea Heating KW' L°1:2-1 M clpal O Coan.eeaon 0 aha No.of Dryers IHeatin.g Appliances KW Security Systems:* No.of Water No. of No.of Devices or Equivalent KW No.of Heaters Ballasts Data Wiring: SignsNo.of Devices or Equivalent ' No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wit-in'- No.of Devices or Equivalent O 11iER • • Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work (IN MO (When required by municipal policy.) Work to Start 51.4511 r 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 covprage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 1311 BOND 0 OTHER ❑ (Specify.) I cer$fy, under the pains and peruddes o(�erjury,that the information on this application is true and complete FIRM NAME: Car/. 7f f/ GIC NO Licensee: S , f%j Signature CZ^c______— (If applicable, enter "teerupt"in the licensenumber line) LIC NO.: 3'7 O'7r E_ Address: Bus.TeL No.: j Per M.O.L.c. 347,s.57-61,securitywork requiresAlt TeL No.:�_ Department of Public Safety"S"License: Lic.No. — OWNER'S [NSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent. s Owner/Agent Signature Telephone No. I PERMIT FEE: $