BLDE-18-003706 A,` Commonwealth of Official Use Only
t1 Massachusetts Permit No. BLDE-18-003706
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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:12/26/2017
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) 38 LEWIS BAY BLVD A'4
Owner or Tenant BRADBURY DAVE Telephone No. 11F� /
Owner's Address 38 LEWIS BAY BLVD,WEST YARMOUTH, MA 02673 .
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Bo \ i't.
Purpose of Building Utility Authorization No. 2252995
Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters
New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: 200 Amp U.G.service and new construction(508-776-1857)
Completion of the fallowing table may be waived by the Inspector of Wires.
No.of Recessed Luminaires 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- 0 No.of Emergency Lighting
grnd. grnd. Batten/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
Initiating Devices
No.of Ranges No.of Air Cond. To
No.of Alerting Devices
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 ❑ Municipal ❑ 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.
CHECK ONE:INSURANCE ❑ BOND 0 OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete. •
FIRM NAME: Neil SChoener
Licensee: Neil Schoener Signature LIC.NO.: 13949
(Ifapplicable,enter"exempt'in the license number line.) Bus.Tel.No.:
Address:44 TRADERS LN,W YARMOUTH MA 026733333 Alt.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) ❑ owner 0 owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$180.00
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r l_omanor-rocc fh of M.o.:A•m-µd Omeal Use Only
cc��,, �s77 ((�� -- .PerlidtNo. SOF -/7-0t1320,6
• i .350¢rimu.E oil ire Jererce0 -
�� �\ Occupancy and Fee Checked
N`�lis
BOARD OF FIRE PREVENTION REGULATIONS Rev. 1107] • ("me blank)
APPLICATION 'FOR:PERMIT TO PERFORM ELECTRICAL WORK\
.All work to be perfa tnd in accordance wit the Massachuserts Electrical Code(MEC),527 ChiR 1200
(PLE,4SEPINNK
RLNTOR TYPE ALL INFORIZATIQ ) Date: Jag r 2,2 - / 7
City or Town of: YARMOUTH To the Inspector of Wires:
. By this application the undenimed gives notice of his or her intention to .morin the d- cal work described below. '
Location(Street&Number) i L.erg1J ���G✓a� N
Own er br Tenant ,../erre- % i 'D&V i Telephone No.
Owner's Address """��"���'�-�
e1 Is this permit in conjunc,tiiiu with a branding permit? Yes rI No ❑ (Check Approprlate Boz) r
Purpose of Building f V Gf/✓ tOt/Se/ Utility Authorization No.n7,2 ' P g9J
`R' Existing Service_ Amps / Volts Overhead E Undgrd❑ No. of Meters
vvv000 New Service -1.-00 Amps /20/ 240 Volts Overhead❑ Undgrd ❑VNo, of Meters 1
Nubber of Feeders and Ampacity
Ci ----IF- 1 Location and Ne.-¢r_of Proposed rEI.ect-inl Work: 7iQ04 (J.CD-. eLGPi 'tot'
LU
cr iEn, .. ._ ___ —. _ Completion of the fofawfn table may be winesed by the inspector of Wires.
.-,,,
No.of Recessed Lamdne res INo.of Cert (Paddle)Fans No.of TVA
Lli C\l otal
:` sP-LP ) Trzarformers ICV A
. , No.ofLumit*a4r_Oatletr INo.vf Hot Tubs 'Generators b�A
0 W ;ere ) 4bov In- rip.ox Lmerg cry L phtmg
o 1 n No.of Luminaires ISwirnming Pool ❑ ❑
Ili i_, I >xxrd. �rxtd. B.attery IIai�
. , --J No, of Rtemptade OarL� No.of Ofl Barriers FMB ALARMS No.of Zoom
-------- No.No. of Switches INo.of Gas Burners
No.of De' non and
Inftia--Devices
No.of Ranges INo. of Air Cont Tons No.of Alerting Devices
•
No.of Waste Disposers 'Heat Pump
1 Number 'Tons Igo.of Self-Contained
Totals: etectioa/Aieriing Devices
No.of Dishwashers • Spacet/Area HSting KW' L°c1-1 0 C mince trop 0 Other
No.of Dryers IHeatingAppliances KW Security Systems:t
No.of Devices or Equivalent
No.of WaterR,W, No. of No.of Data Wiring:
Heaters Signs Ballasts Na.of Devices or E•uivalent
' No.Hydromassage Bathtubs No. of Motors Total HP elecommnniices o s Equ'Irivalent No.of Devices or Egniv&nt
S O 11d1:R '
1- Attach additional derail if desired or as required by the Inspector of Mires.
,j Estimated Value of Electrical World 3'GUI (When required by municipal policy.)
Work to Start /7.- 71-17 Inspections to be requested in accordance with NEC 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 ice including"completed operation"coverage or its substantial equivalent The
I undersigned certifies that such cover. ,,is m force,and has exhibited proof of same to the permit issuing office.
en
CHECK ONE: INSURANCE BOND ElOTIfR 0 (Specify^.)
I certify,render the p and pen hies of perjwp,that the information on this application is true and complete.
FIRM NAME:Je„t (, SOKp€.vf4J' /\6d y/G/IC LIC NO: #739Yt
lam ' Licensee: Signature ! pt8`r� LIC.NO.:
a /Leable, 5h �.e/,� t iq t e!' bar/' ,e f�,,� �/ Bus.TeL No:.eAQ9�y�-
Address. '� 6 TYR(LYIf�� WVOJ u �Ot/!r7 f7a7,',yltTel.No.:`Jvo r /1O1 r
j Per M.G.L.c. 147,s.57-61,security work requires Depa4ent of Public Safety"S"License: Lie.No.
—a OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's agent
1 Owner/Agent I PERMIT FEE: S l
iii Signature Telephone No.