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HomeMy WebLinkAboutBLDE-18-002409 � : '(%V Official Use Permit No. BLDE-18-002409 b Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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:10/23/2017 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. / //nq �� Location(Street&Number) 25 AUNT JANES RD 4'1g—7z-G #A/ Owner or Tenant GROSECLOSE MARGARET SHAY Telephone No. Owner's Address CIO PARSONS MICHAEL J, 131 CRAFTS ST,NEWTONVILLE,MA 02158 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 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Wring for in-ground swimming pool. 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 ❑ ln- CINo.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. Tota l No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons jKW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal ❑ 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 IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desirecL 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: Derick A Greenaway Licensee: Derick A Greenaway Signature LIC.NO.: 21422 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:5 HERGET DR,UNIT 5A,PEPPERELL MA 014631315 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:$85.00 aj, oM /!cYL BLL A I rdittdr J ?C yliNtil t(atertAIL CocvoLiaz 012 rf/,/, "7rc cir7R-2813-43"080 tx t\►ta ritrrRt. taXIts ftu4c- ra(2lta et 1 .-. n Cmman+uealg el Madder ade OEiciina Use Oil �% Ct'7� c7 [� 'l.Permit No. p"2-,_U JJc/aa.�lmsnf of.lira Serviced - BOARD OF FIRE PREVENTION REGULATIONS Oceupanry and Fee Checked (Rev. 1/07] (]cave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordance with the Massachusecs Electrical Code(MEC),52 CMR 12116 (PLE,4SEPRINT ININK ORTYPE ALL INFORMATION) Date: /Q�� l� City or Town of: YARMOUTH To the Inspector of Wires: By this application the lmdersigned gives notice of his or her intention to perform the electrical work described below. Location (Street&Number) 2. g ck.✓NT- 3a Al ES R D • Owner'orTenant /4/RP Pa. F!O SVS Telephone No. P c7,[ 1:1, - Owner's Address Yr Ill I o . Is this permit in conjunction with a building permit? Yes No Bo ) 'I N z . .._. ❑ (Check Appropr ate Box) i rp i i Purpose of Building H De? ! 1 1�, Utility Authorization No. t`'}- I Existing Service Amps / Volts Overhead E. Undgrd❑ No.of Meters 6' V New Sery ce O Amps / Volts Overhead❑ Undgrd❑ No.of Meters • i. __I:3 > Number of Feeders and Ampacity ' r Location and Nature of Proposed Electrical Work-. PO© L �a1t7 St✓/nr�) /,ilS Complrnnn of the followinet table may be waived by the Inspector of lyres, No.of Recessed Luminaires INo,of Cei1.-5'usp.(Paddle)Fans • No.of Total (Transformers (CVA No. of Luminaire Outlets INo.of Hot Tubs IlLnnnSSl���[[[!!! Ge erators • KVA ' - No. of Luminaires ISwfmming Pool Above 0 Ln_d. o.of r mes-gency Lighting and. ertrBatten Units © No. of Receptacle Outlet No.of Oil Burners 'ETRE ALARMS INo.of Zones No. of Switches No.of Gas Burners No.of Detection and Iaitiatina Devices ' No.of Ranges Total INo.of Air Cond. Tons No.of Alerting Devices Q No.of Waste Disposers Heat Pump I Number Tons KW No.of Self-Contained Totals: _ Detection/Alertino Devices No.of Dishwashers Space/Area Heating KW' -int CMonunnicectioipal � n �. No. of Dryers (Heating Appliances ,r Security Systems:° O No.of Water No,of Devices or Equi ` valent _ Heaters KW No. of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent d No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications\tiring: No.of Devices or Equivalent 3 OTHER: p r r ©D^ Attach additional detail ifdesired oras required by the Inspector of Wires. 4 Estimated Value of lectricil Work: [I f V (When required by municipal policy.) Work to Start / a / P ) Inspecfions 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 it substantial equivalent. The undersigned certifies that such coy ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify.) I cent)", under the pains�and pennk;es of perjury,that the information on this application is true and complete. FIRM NAME: SLS/f �G1'96, r /Q L4� —� P �L��r�77 4 LIC NO.: o�/�o Licensee: F&/ACGf IJ Q) F� ' C!/a Signature IC.NO.: / (Ifappliccbl entyr"rsgmpt"inef, !lapse g�(,ye. y, /• Bus.TeLNo: nen/ Address. 3L( /7'/-G'e1 O7 Birt/ &Lli/J1AC 8/In7 / ' J "Per M.G.L. requires Department of Public Safety"S"License: Lic.No.G.L,c. 147, s.57-61,security work —" AIG Tel.No i— OWNER'S INSURANCE WA �_WAIVER: I am aware that the Licensee does nor have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑ owner 0 owner's agent n Owner/Agent 01 Signature Telephone No. I PERMIT FEE: $