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HomeMy WebLinkAboutE-19-1092 Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-001092 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked f Rev.I/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:8/22/2018 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) 85 WIANNO RD Owner or Tenant RING RONALD J Telephone No. Owner's Address RING ERNESTINE J,85 WIANNO RD,YARMOUTH PORT, MA 02675 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 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: Fix double tapped circuit breakers. Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ce11.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- 1:1No.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 initiating Devices No.of Ranges No.of Air Cond. Total 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 ❑ 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. CHECK ONE:INSURANCE 0 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: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address: 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) 0 owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 N9,- e(2 7a e 41Bileet . L.ommonroea&e/cc7Mamac t& O trial Use Only 1Z-2.m 1Jeparfinent oi-Yin Serviced Permit No. � min \ -jf- ' Occupancy and Fee Checked v\J • `N BOARD OF FIRE PREVENTION REGULATIONS (Rev. lir peave blank) 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 INFORM TIOA9 Date: —�� Ap� City or Town of: YARMOUTH To the Inspec or of Wires: • . By this application the undersigned gives notice of his or her intention to perfo the electrical work ed below. • . Location(Street&Number) 75 t/ jiljeta ,* i � irleuy�G rnbtart�11 OwnerbrTenant /1C�l� / Telephone No.71y ,117," 4./13 Owner's Address _Saj e l Is this permit in conju�" ti�on with a building permit? Yes 0 No (Check Appropriate Box) Purpose of Building aSfzle�7C� Utility Authorization No. Existing Service_ Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service Amps / Volts Overhead 0 Undgrd0 No,of Meters Number of Feeders and Ampadty 0 z Won 5 o ado!'and Nature of Proposed Electrical Work: 15.)cL7 Do a /L D /J �f W I /� ~ Completion of the following table may be waived by the Inspector of Wires. y N N of Recessed Luminaires No.of Cell.Svsp.(Paddle)Fans No.of •y CitTotal W r^ Transformers KVA - ,L of Luminaire Outlets No.of Hot Tubs Generators KVA V CD . V l Above In- No.ottinergency Lighting ' of Luminaires Swimming Fool arnd. ?rad. 0 Battery Units Cer of Receptacle Outlets . No.of Oil Burners FIRE ALARMS INo.of Zones of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Too No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number!Tons I KW No.of Self-Contained Totals:j Detection/Alerting Devices No.of Dishwashers • Space/Area Heating KW Local El Municipal Connection 0 °ther No.of Dryers Heating Appliances KW Security Systems:" No.of Water No.of Devices or Equivalent Heaters No.of No.at Data Signs Ballasts No.of KW Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Wort` /bb— (When required by municipal policy.) Work to Start: 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 0 BOND 0 OTHER 0 (Specify:) I certify, under the pains and penalties ofperjuty,that the information pn this application is true and complete. FIRM NAME: LIC.NO.: Licensee: Signature LIC.NO.: (If applicable,enter"exempt"in the license number line.) Address. Bus.Tel.No.•_ J 'Per M G.L c. 147,S.57-61,securitywork requires _ Alt Tel.No.: — OWNER'S INSURANCE WAIVER I am aware that thaeLicensee does not have the liability insurance coverage normally c.No. �e required q� by la By my signature belo eby waive this requirement I am the(check one)ID owner ❑owner's agent. t Owner/Ageet� Signature TelephoneNo.77ri--VC1 -wr.gI PERMIT FEE: $ 50