HomeMy WebLinkAboutE-19-1437 or Commonwealth of Official Use Only
Massachusetts Permit No. BLDE-19-001437
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
f Rev.I/071
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:9/11/2018
City or Town of: YARMOUTH To the Inspector of Wires:
By this application the undersigned gives notice of nis or her intention to perform the electrJJi�at work described below. ,w• - `�
Location(Street&Number) 62 OLD HYANNIS RD /A NO Q -tv/ �/
Owner or Tenant LEBEL LAURIE SNOWDEN TR Telephone No.
Owner's Address THE ASA ELDRIDGE RLTY TRUST,P 0 BOX 170,WEST HYANNISPORT, MA 02672
Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box)
Purpose of Building Utility Authorization No. 2295156
Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service 100 Amps Volts Overhead 0 Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Temporary service.
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Cell.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ ln- ❑ 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
Initiatine 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/Alertine 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.
CHECK ONE:INSURANCE 0 BOND ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application Is true and complete.
FIRM NAME: Arthur P Doherty
Licensee: Arthur P Doherty Signature LIC.NO.: 17197
(Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:372 YARMOUTH RD,HYANNIS MA 026012043 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,secunty 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 �J�r n p /l,— / ��66��Telephone No. PERMIT FEE:$50.00
AP
e1` - l.om,nona sa o�e/7//auach,,..kl Offic(iaall Use Only
• N isryg Zepa hent /.7.i,..services t ` ` ' `-��
x i of . Permit No. I
-__11=
- BOARD OF FIRE PREVENTION REGULATIONS [ Occupancy and Fee Checked
. I/07] (leave 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 IND K OR TYPE ALL INFORM4T70A9 Date: 5p�7 7� 20 ig
f City or Town of: YARMOUTH To the Inspector of Wires:
/ t y this application the undersigned gives notice of his or her intention to perform the electrical work described below.
o . 1 ocation(Street&NumbG
• w Number) 2 (J/,1J f-1yyl,ttr,)i g 1ZD XArmou7H0Or7
W m • �s wneror Tenant �J f,5re__~ /��( Li M A ri AIp Telephone No.
RI
> RI ¢ IIwner'sAddress
W t 1 o s this permit in conjunction with a building permit? Yes 0 No .gi (Check Appropriate Box)
o e---`` 2 �,'urpose of Building Utility Authorization No. 229 SI SG
W � ° xisting Service_ Amps / Volts Overhead
0 Undgrd❑ No.of Meters
CC m ..! ew Service /DO Amps /20 /Zqq Volts Overhead 0 Undgrd 0 No.of Meters
amber of Feeders and Ampacity
Location and Nature of Proposed Electrical Wort -72.mipo rAry
SLC-[)i 4-4--
• Completion of thefollowinttable maybe waived by the Inspector of Wires.
No.of Recessed Luminaires No.of CerizSasp.(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.oTkmergency LtghVig
grnd. zrnd. ❑ Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones
No.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'Number I Tons I KW No.of Self-Contained -
Totals: Detection/Alerting Devices
No.of Dishwashers Space/Area HeatingKW Municipal
Lone
0Other
No.of Dryers Heating Appliances KW 'Security Systems:'
No.of Water No.of No.of Devices or Equivalent
Heaters No.of Data Wiring,
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 desiretj or as required by the Inspector of Wires.
Estimated Value of Electrical Work (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 ❑ (Specify:)
I cert)",ander the pains and penalties of pedal'',that the information on this application is true and complete.
FIRM NAME: 6AYSi Qe.-• EI Iccrr,"(A L Cr UT G7-o t-S LIC.NO.: U 7
/12
Licensee: jP7,,,sn Castel/0 Signature LIC.NO.:
(If applicable,enter"exempt"in the license number fine.)
Address. r • 44 L • a .n f A• 026e Bus.TeL No.�_
J 'Per M.G.L.c. 14 ,s.57-61,securityworky Alt Tel.No.: 8_� pbp4
License: Lic.No.
— OWNER'S INSURANCE WAIVER: I am aware that a Licensees does not have the liability insurance coverage normally l
Q required
q by law. By my signature below,I hereby waive this requirement lam the(check one)El owner El owner's agent.
r Own nt
Signature tura• Telephone No. ( PERtbIITFEE: $ 50