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HomeMy WebLinkAboutBLDE-19-000263 t,. t,.. Commonwealth of Official Use Only ktel% Massachusetts Permit No. BLDE-19-000263 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.1/071 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:7/12/2018 i City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pet-torm Inc e' lc 1 work d ' ed below. Location(Street&Number) 211gPLEASANT ST (/ Owner or Tenant HIGBEE TOM M TRS Telephon No. Owner's Address HIGBEE DIANE F,211 PLEASANT STREET #A, BASS RIVER, MA 02664-4552 Is this permit In conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ 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: T - 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 1 KVA No.of Luminaires Swimming Pool Above ❑ In- o 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 i 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 I 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: Peter C Fruean Licensee: Peter C Fruean Signature LIC.NO.: 27553 (If applicable,enter"erempi"in the license number line.) Bus.Tel.No.: Address:137 PRINCE HINCKLEY RD.CENTERVILLE MA 026322149 Mt.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 awn 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 Signaturep Telephone No. PERMIT FEE:$50.00 t�R- l 11 /e l4) � P� C&& K = ce-Lb q (2ee(.eIce__- .t .5 , Cutunonanealg o`Mataciwrta /O�fficcipal Use Only ryty cc77� �s Permit No. � 1j ( ' © G el 65 Him 2 and of in Service! = er • "� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/01 ' peeve blank) APPLICATION FORPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINTININK OR TYPE ALL INFORMATION) Date: i ICity 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. > . N a Location (Street&Number) 211 ' , Hetts44t1t ST > a Owner•orTenant `j Sef � - ' S�i�1� y Telephone No. An L11 ° Owner's Address V - o IIs this permit in conjunction with a building permit? Yes 0 No (Check Appropriate Box) W urpose of Building � r Utility Authorization No. r - m m xisting Service 106 Amps (20 / 2.410 Volts Overhead cr Undgrdt, ❑ No.of Meters New Service Amps / Volts Overhead❑ Und Led 0 No.of Meters Number of Feeders and Ampacity Locatiqn $atgre of Proposed Electrical Work; £41 61' b :. - e4ceLv./\ l/,•ns1l 1e se (M 4 4 d. GaL Completion of thefollowin�table may be waived by the Inspector of Wirer. No.of Recessed Luminaires No.of CeR.-Snsp.(Paddle)Fans No.of Total ' Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Fool Above ❑ In- No,of f:mergency Lighting grnd. crud. BatteryUnits No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Coml. Ton No.of Alerting Devices No.of Waste Disposers Heat Pump'Number Fons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal - 1'0�0 Connection ❑ Oiler No.of Dryers Heating Appliances KW Security Systems:' No.of Water No.of No.of Devices or Equivalent Heaters No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical World (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify:) I cen$fy, under the a' and penalties of perjury,that the information on this application is true and complete FIRM NAME: !!/ LIC NO.. Licensee: rel/ZoCA.t�1 Signature f l LIC.NO.:117 S 3 (If applicable,enter"exempt"in the license number line) �1 I��KCIo (( �r ly D GQs� i/,'i kik- Bus.Tel.No.:fft<-kc�n-STrea Address: t3k Safety Alt.Tel.No.: J "Per M.G.L.c. 147,s.57-61,security work �_ quires Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage n— required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent 1 Owner/Agent 01 Signature ' Telephone No. I PERMIT FEE: S