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HomeMy WebLinkAboutE-19-2082 J.// Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002082 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked VRev.l/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:10/9/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perlorm the elcctr1 work describet'belowt, Location(Street&Number) 312&314 WINSLOW GRAY RD IJ✓Ii^Tw1 vxu `� ID a Owner or Tenant MCAULIFFE TIMOTHY J JR TR Telephone No. Owner's Address THE KSK REVOCABLE TRUST, 12 GLEN RD, HYANNIS, MA 02601 Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service Amps Volts Overhead ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement burner. 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- 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 1 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/Alertine 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:) f certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Jeffrey T Foss Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter'exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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 0e4 iii4'obe Let /J yy��jj = Lommuon, ca& of/t/addac�ette _•_, ( ‘ Olnci�l Use Only ,'.V4 I _ ��� c� c7 (� Permit No.a[Jl— cC/�1^8 - V ti ` alp apartment of Jiro Serviced G Occupancy end Fee Checked BOARD OF FIRE PREVENTION REGULATIONS Rev. l/07j " pczveblank) --T---- APPLICATION FO.RJPERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code WC),527 ' in t' (PLEASE PRINT IN INK OR TYPE ALL INFORMQTI01VV Date: 9 7 City or Town of: YARMOUTH To the Inspector o FYi es: By this application theand , gursn ed • gives notice of his or her intention to perform the electrical work des bed below. Location (Street&Number) �' / 1� eW ilia5kW /le yr e2 Owner'or Tenant /JJ� llfA ON -f"']� / L Telephone eNNa.7j -d3 q� Owner's Address - ,Z Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Bnilormg Utility Authorization No. Existing Service hit Amps /k)ii 92)Volts Overhead Undgrd ❑ No.of Meters .2_ New Service _- Amps I Volts Overhead❑ Undgrd❑ Nd.of Meters Number of Feeders and Ampacity • -- Location and Nature of Proposed Electrical Work: �4//!/`� fru W a/]s 1j�,,ace - KXi 1SliiOfr c,ilcu,� l .. . Completion of the following,table may be waived by the Inspector of Wirer. No.of Recessed Luminaires INo, of CetlSusp.(Paddle)Fates INo.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs (Generators • !CVA . No.of Luminaires ISwimn,iag Pool Above In- INo,of time.-genet L,�hung . ern& arnd. SattervUnits No. of Receptacle Outlets . No.of Oil Burners IMRE ALARMS INo.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices Total No.of Ranges • INo. of Air Cond. Tons No.of Alerting Devices • No.of Waste Disposers (Heat Pump 1 Number Tons KW INn.oTScrf-Contained Totals:I Dettxtion/Alertine Devices No.of Dishwashers ISpace/Area Heating KW' Local Municipal Connection 0 Otho No. of Dryers (Heating Appliances ICW Security Spstems:• V No.of Water No. of No.of Data WirNo.ofingviees or Equivalent Heaters Signs SiBallasts Q,e No.of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommnnicatioas Wiring: Na of Devices or Equivalent O I iiLR • Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of E .: al . or (When required by municipaloli q Work to Start /0 p �� Inspections to be requested in accordance with MEC Rule 10,and upon completion. ...,.....'II ` INSURANCE C+ • GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability instuance 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. ‘ i CHECK ONE: INSURANCE BOND I certify,ander the pains and en Ines o OTHER 0 inf(Speormation on �app(/,e C�1 completed e.fPUltuy,that the infot•tna8on this application Es true and roatpfete. / 01 FIRM NAME: LIC NO Licensee: 1 1 • h flfapplicablin, Signature LIC.NO.: ��� ... .mb �7 )Address: 1//bdiifiti T ati- DA(23 Bus.TeL No.: Alt TeL No.:liter Q j "Per M.G.L. c. 147,s_57-61,security work requires Department of Public Safety S"License: Lie.No. - OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally S required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent. t Owner/Agent Signature Telephone No. I PERMIT FEE: $