HomeMy WebLinkAboutE-19-2070 ����� Commonwealth of Official use only
Massachusetts Permit No. BLDE-19-002070
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
JRev.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 nofice ofhis or her intention to perform the electrical work described below.
Location(Street&Number) 6 SHAKER HOUSE RD
Owner or Tenant KOHR JOHN ROBERT TRS Telephone No.
Owner's Address KOHR JEAN M TRS,6 SHAKER HOUSE RD,YARMOUTH PORT,MA 02675
Is this permit In conjunction with a building permit? Yes 0 No ❑ (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 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Install generator&switch panel.
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- ❑ No.of Emergency Lighting
grnd. grad. Batten 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 ❑ 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: EDWARD L MERRY
Licensee: Edward L Merry Signature LIC.NO.: 17137
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:15 CHECKERBERRY LN,W YARMOUTH MA 026733636 Alt.Tel.No.:
"Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"5"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
dik Commonwealth of Massachusetts Offigialyse Only
„'~ t Department of Fire Services Permit No. J
4 -2470
3t4?> BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
. [Rev. 1/07] (leave blank)
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: 9-21-2018
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) 8 Shaker House Rd
Owner or Tenant Robert&Jean Kohr Telephone No. 508-641-0310
Owner's Address same
Is this permit In conjunction with a building permit? Yes 0 No a® (Check Appropriate Box)
Purpose of Building Residence Utility Authorization No.
Existing Service 100? Amps 120/40 Volts Overhead 0 Undgrd 0 No.of Meters 1
New Service Amps Volts . Overhead 0 Undgrd 0 No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Stand by generator Install with 16 circuit transfer panel
Completion of the following table may be waived by the I ctor of Wires.
No.of Recessed Luminaires No.of Cell.Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outleb No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ 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 Spare/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.Hydro massage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if devre4 or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: will call 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 coverage is in
force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE 0 BOND 0 OTHER 0 (Specify:) GENERAL COMP.LIABILITY 06/24/2019
(Expiration Date)
I certify,ander the pains and penakia ofperjury,that the Information on this application Is true and complete.
FIRM NAME: Ed Merry Master Electrician Inc. /� //� 1// , LIC.NO.:A17137
Licensee: Ed Merry Signature (.1 .l t LIC.NO.: 35745E
(Ifapplicable,enter "exempt"in the license number line) Bus.Tel.No.: 508-221-4335
Address: 15 Checkerberry lane West Yarmouth,Ma,02673 Alt.Tel.No.:
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License:here: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By
my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's a ent.
Owner/Agent PERMIT FEE:f
Signature Telephone No.