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Home My WebLink AboutBLDE-18-6339 e Ja Commonwealth of Official Use Only Allik Massachusetts Permit No. BLDE-18-006339 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked !Rev.1/07) 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 PR/NT ININK OR TYPE ALL INFORMATION) Date:5/14/2018 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 clean work escribed clow Location(Street&Number) 40 CROSBY ST EXT /jr'd' Owner or Tenant ST OF) Telephone No. Owner's Address ,40 CROSBY ST EXT,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate�B�ox�) Purpose of Building Utility Authorization No b pk Z.5 °t' Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 400 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install service. Completion of the following 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- o No.of Emergency Lighting grnd. grnd. Battery Units AA No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS jNo.of Zones C> No.of Switches No.of Gas Burners No.of Detection and 1- Initiative 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 r No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Other: ya 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 y 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. M INSURANCE COVERAGE:Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee "`"VVVIIjJ 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 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Wayne N Diamond Licensee: Wayne N Diamond Signature LIC.NO.: 37015 (If applicable,enter"exempt"in the license number line.) Bus.TeL No.: Address:10 BLUE HERON CT,EASTHAM MA 026423341 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 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $50.00 �r ,.3Cet t Omuta- 0,046 K— �'��4v1✓ GE ®A- g,�., 6bctic_ worse---41/2-1d c/j e W 7a/ CR- /&/ ��aa yyyy 0' l�ommonw of///aseac its Official Use Only =�_ Apartment c7 p a1 g -CP39 9 .Department o f.yin Serviced Permit No. )'� ' Occupancy and Fee Checked '' BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07j ' (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 IN INK OR TYPE ALL INFORMATIO ) Date: _Voll e City or Town of: YARMOUTH To the Inspe for f Wires: 0 ur 'y this application the tmdersigned gives notice of his or her intention to perform the electrical work described below. 2 i0•cation (Street ilk Number) 4k? ' (r('nSbyC.S • a al 'erorTenant / r ) 0kr Telephone No. —'e4 o 'er'sAddress SAinC alT Zs f iis permit in conjunction with a building permit? Yes ® No 0 (Check Appropriate Bar) V �n .ase of Building � 'pale f Utility Authorization No. in ito = '•. • Service Amps / Volts Overhead In Undgrd❑ No.of Meters Et w Service 9nn Amps Po /o?[JV Volts Overhead 0 Undgrd J No.of Meters j Number of Feeders and Ampacity b - .3/0 COAne r -13 N . • Location and Nature of Proposed Electrical Work: ti4vn� I x)0,14.U tIn-lr TU r- FAb Pr<'OrAIdc r �-��Q Srruiee Completion of thefollowinrirable may be waived by the Inspector of Wires. No.of Recessed LuminairesNo.of CeiL Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators INA No.of Luminaires Swimming pool Above ❑ In- No.onmergency lighting - ttrnd. gruel. ❑ 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. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump i Number I Tons J KW No.of Self-Contained Totals: I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW' Leal Municipal ❑Connection 0 Other No.of Dryers Heating Appliances KW Security Systems:' No.of Water No.of Devices or Equivalent No.of Heaters Kai No.of Data Wiring Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - Na.of Devices or Equivalent OTHER: - _ Attach additional detail it-desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: gpot> (When required by municipal policy.) Work to Start: S ) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: 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 cernfy, under the pa' and penalties ofperjury,that the information on this application is true and completes FIRM NAME: PiI5/A tC 7:3e none,A l4 Est I LIC.NO.: S Licensee: Signature // / �� ' L1 eana,,,( LIC.NO.: (Ijapplicable,enter"ezemp["i the license r umb r line) Bus.Tel.No.: l�j Address: jn blur Y'1rroAi r+ b Etris HIicit+,t levi4 0064a. J Per M.G.L.c. 147,s.57-61,securitywork requiresyAlt Tel.No.: — OWNER'S INSURANCE WAIVER: I am are that theL icer Licensee Publicoes not have the liability insurance coverage normally required by law. By my signature below,I hereb waivethis Owner/Agent y r equiremrnt I am the(check one)0 owner 0 owner's agent Signature Telephone No. ..... I PERMIT FEE: $