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Home My WebLink AboutBLDE-19-1207 r a. Commonwealth of Official Use Only E Massachusetts Permit No. BLDE-19-001207 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 PRINT IN INK OR TYPE ALL INFORMATION) Date:8/28/2018 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 eletctri j. fork descrijned below. Location(Street&Number) 40 CROSBY ST EXT f4 U` C. t_ Owner or Tenant GREENE MARJORIE J TR(EST OF) Telephone No. Owner's Address GREENE DRAGON RLTY TRUST,40 CROSBY ST EXT,SOUTH YARMOUTH,MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Boa) 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: Wiring 2 water heaters, HVAC,&install generator. 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- 0 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 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 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 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: 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,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 Telephone No. PERMIT FEE:$50.00 N (coat- usba filtAt J Ql,/e ka \VP . �s yy hY ` Comas;uom of//[assaeialft Official Use On �V = �' ryry, �7 �7 :Permit No. 1. t ` :�'m 1JsParimsnl a f.Vire Jeroice! 11 Occupancy and Fee Checked - = BOARD OF FIRE PREVENTION REGULATIONS ev. 1/07) ' (leave blank) • APPLICATION FOR,PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(ME ,527 12.00 (PLEASE PRINT IN INK OR TYPE ALLINFORMAT1019 Date: , gel )e City or Town of: YARMOUTH To the Inspector of fres: By this application the Imdersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Yn (I ras)1.2- ii-, qt Owner.or Tenant I42) 0 Ice Telephone No. Owner's Address Sw,r)r acrit —1 Is this permit in conju u with a blinding permit? Yes ® No 7 0 (Check Appropriate Ba:) Purpose of BuildingGS j1'�n � Utility Authorization No. Cl- xsting Service Amps / Volts Overhead 0 Und LJ I wgid❑ No.of Meters �m i is n Service I/00 Amps /Oa/air,Volts Overhead 0 UndgrdEl f4Sl No,of Meters / c`�.t QlWvsber of Feeders and Ampacity Wco ketation and Nature of Proposed Electrical Wort - e V c� Cyslr»1 e r Itxtict,rCl4re r`A1 Ont t trltC ri, lrlvai n) 1 n rIC • W Oa' 'e I rr 9rt..3 Sy.1/4-trim • Complenon of thefollawing table may be waived by the Inspector of Wirer, r of Recessed Luminaires No.of Cert-Susp.(Paddle)Fans o.of Total ed Transformers KVA -% )a,p" Generators Luminaire Outlets nMe No.of Hot Tubs KVp No.of Luminaires Swimming Pool Above O ln- No,of Emergency Ltghtmg grad. errtd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones Na.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!Number uI Tons I KW No.of Self-Contained ll Totals: Detection/Alerting Devices 2 No.of Dishwasher Space/Area Heating KW' Local 0 Municipal Convection 0 °t'? No.of Dryers Heating Appliancesy Security Systems:" No.of Water No.of No.of Devices or Equivalent Heaters No,of Data Wiring; Signs Ballasts No.of Devices or Equivalent Tel w No.Hydromassage Bathtubs No.of Motors Total AP ecommunications Wiring: — Cl No.of Devices or Equivalent OTHER: Attach additional detail 04-desired or as required by the Inspector of Wires, Estimated Value of Electrical Work: 4,)fin (When required by municipal policy.) Work to Start: 4, la-JJ er Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE OVERAGE: 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. Q CHECK ONE: INSURANCE I_ BOND 0 OTHER 0 (Specify:) r I certify, under thepfitis and penalties ofperjury,that the inforrnation on this application is true and complete, , FIRM NAME: ,44y A37- 0-t f ytnr,A,(2 1 A,C. ., LIC NO.: WE 1 Licensee: Signature /� '/� (If applicable,enter"exempt.*in the license number line.) LIC.NO.: Address i[Th -211)C }tprni) !,.{' FrAS�llgni. }vilq 404,1 end Bus.Tel.No.: 3� _ j 'Per M.G.L.c:147,s.57-61,securityworkAlt Tel.No.: — OWNER'S INSURANCE WAIVER: I am requireswware tha�hLicensee doe.,not ave the License: insurance coverage �— ic required bylaw. Byliabilityo 0w coves a n a�al y 9� my signature below,I hereby waive this requirement. I am the(check one) owner El owner's agent t Owner/Agent al Signature• Telephone No. 1 PERMIT FEE: $ 6D- 1