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HomeMy WebLinkAboutBLDE-18-004478 Commonwealth of so Official Use Only m. Massachusetts Permit No. BLDE-18-004478 __ __:1 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:2/9/2018 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 electrical work described below. Location(Street&Number) 15 POWERS LN ^ Owner or Tenant BRUNO BEVERLY A Telephone No. Owner's Address 83 CIDER MILL RD, HAWTHORNE,NJ 07506-3042 1 �rA Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) 'jjf%" . -/S Purpose of Building Utility Authorization No. 2262372el Existing Service Amps Volts Overhead 0 Undgrd ❑ No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: New residence 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 0 In- 1:1No.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 Ton. No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Arealleating 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 desire4 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: Neil Schoener Licensee: Neil Schoenen Signature LIC.NO.: 13949 (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:44 TRADERS LN,W YARMOUTH MA 026733333 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:$180.00 goak '2124 11 e r---e-- ( cfrmg-t. SEW-gy Tye-€i@C©&ovi-r fait 2&nee f S(ITT1C, Wij// 6 lam. S.19-143-we ga//ekb/?,p l L RAMC ?lWWM6 _---r---------_- 1 Crmrnprur.¢L17s nF///¢5aae�•,tSefJ •-ealU eOn/'ly//�� c'� - .�t..y I 3 H . partminf c{.. L&rvi.ccea BOARD OF ARE PREVENTION REGULATIONS Oc. 1/07) aadF a lank Checked �ev. 1/07] (]cave bletil:) APPLICATION FOR;PERMIT TO PERFORM ELECTRICAL WORK 1 .All work to bepercorned in accordance with the Massaehus-_os Electrical Coda(MEC),527 OMR 1200 (PLEASE PLENT ININK OR TYPE ALL INFORM1270N) Date: Z 1 S /i & cqiCity or Town of: YARMOUTH To the Inspector of Wires: By this application the Imdenigred gives notice of or her intention to perform the electrical work de cubed below. • Location(Street&Number) �j !n/E4.—S /� CA/ tsr q�c�not-/7l Owner orTen ant 5 e ver- 1/ 0 Telephone No. Owner's Address - Is this permit in conju,n,cp'on with ab�7ding permit? Yes !/ No U (Check A ro 0 L. ' Purpose of Bmloing !V•-CMS ti-�'�� — PP P �Boz) W Utility Authorization No. 2,2 6723 7,-• `o Existing Service Amps / Volts Overhead ❑ Dndgrd❑ of Meters ND 't` Amps Volts Overhead l ce New Service 1,1j ❑ Undgrd No, of Meters Number of Feeders and Ampacity as W Location and Nacre of Proposed Electrical Work ITL /VOW / )v,.[e— . /48hae- Ill "- ° 2--d0 4 0 . a Scr✓t,%-e...- ce m m Comps ofthealtaws,t table f may be waved by the lrspenor of Wires. No.of Recessed Lnnt„et-es INo.of CeB.-Srsp.(Paddle)Fans • INTrnsoa,of Total formers KVA No.ofLnminaireOutie~r !No.rof Hot Tubs (Generators • KVA ' No,of Ltrn:in2ireS ISwimmiagPDal Above ❑ In-de IB❑ No, atterqUof amergeenvy 1.,cgatmg — Brad. etunits No. of Receptacle Outten . �NCI.of OH Burners !FIRE ALARMS INo.of Zones No.of Switches No.of Gas Em-nets No.of Deters:13 and • Inith z Devices No.of Ranges Na Total No.of Alerting Devices of Air Coad. Tons No.• of Waste Disposers (Rest Pump !Number Tons KW INn.of Self-Contused Totals: Det:ctionL4iertinv_Devices No.of Dishwashers • Space/Area Heating KW' (ILocal 1i4'��� 1 ❑ Coaneeiion ❑ ? No.of Dryers Heating Appliances K Security Systems:r K . No.of Water KW No.of Devices or Equivalent Heaters No. of No.of Data Wirng Siens Ballasts No.of Devices or Equivalent 1 No.Hydromassage Bathtubs No.of —Total IiP Telecomm enications Wiring: — No.of Devices or Equivalent OikitR • • Attach additional detail if desired or a required by the Inspector of Wires. Estimated Value of El-chical Wort' /5• oe0 (When required by municipal Work to Start G2 G —1 B mPapolicy.) Inspections ctions to be requested in accordance with MEC Rule 10,and upon completion INSURANCE CO RAGE: Unless waive the owner,no permit for the performance of electrical work may issue tapas the licensee provides proof of liability i ce including"completed operation"coverage or its substantial equivalent The undersigned certifies that such cove a is in force,and has exhibited proof of same to the permit issuing office.CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify, under thAppts aS encdfi_es o p f cIaTJ,a�the information on this¢p kcation it true and comp! FIRM NAME et t ( Sc: o 6'4 C-re---id s^�t p I LIC NO. II / y� Licensee: Signature (Ifapplicable, t � LIC.NO.: '���t�o��th�e� lice a er/m-e1r Bus.TeL No. Address. 7S ' r f/L(/t� ��m�iV•�57 / '10�f �14;07-C•7 �� TeL No j `Per 1.2 G.L.c. 147,s.57-61,security work ray ui,�.,D went of Public Safety"5"License: Alt Lie.No.� — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S requiOwred/by la w By try signature below,I hereby waive this requirement I am the(check one)0 owner ID owner's agent tSignature Telephone No. 1 PERMIT FEE: S