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HomeMy WebLinkAboutDE-19-2879 or \`�� Commonwealth of Official Use Only E_�;0 Massachusetts Permit No. BLDE-19-002879 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:11/9/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertomr the electrical�y�work��Amin below. Q Location(Street&Number) 25 POND ST '54 A in 1'7I^2(c$ —7021 ' Owner or Tenant CLIFFORD JASON Telephone No. Owner's Address CLIFFORD SHANNA L,25 POND ST,SOUTH YARMOUTH, MA 02664 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 2305995 Existing Service 100 Amps Volts Overhead ❑ Undgrd 0 No.of Meters New Service 200 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Upgrade service&install generator. 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- 13No.of Emergency Lighting grnd. grn . 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 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 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: Shawn M Ricard Licensee: Shawn M Ricard Signature LIC.NO.: 40451 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:27 BAYWOOD DR,ORLEANS MA 026534815 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 S t( I131 (8 free M1 '- ` l.Ommonwea o�Massachusetts Official Use Doty 4?...,( }-4_— 619 ^2� _`al r apartment of.}ire Services Permit No. 1 1 =1+ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS . Iro71 ' (leave blank) - APPLICATION FOR.PERMIT TO PERFORM ELECTRICAL WORK All wort to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLE. SEpRfyv7Jpqjç OR TYPE ALLINFORMATION) Date: U- 1-I g City or Town of: YARMOUTH To the Inspector of Wires: By this application the pndetsigned gives notice of his or her intention to perform the electrical work described below. I Location (Street&Number) ZS ?o n d S\'rjy7 11� �� Owner'or Tenant -Et\so,-. C\; Ccnr 4 Telephone No.-)7�(Z,- ;LIG Owner's Address J5 Bond e gr fit t) . ) g �<s Id Is this permit in conjunction with a building permit? Yes 0 No ® (Check Appropriate Purpose of Buildia Z Box) enh� Utility Authorization No, X30 5495 E ' n ServiceE. Und I p g Amps Mo / `\`tV Volts Overhead W \ -- z grd❑ No.of Meters / `.0 2 e Service �n Amps /a., /ayb Volts Overhead (� , © Undgrd❑ No.of Meters _L �N t�Vla2ii her of Feeders and Ampacity • -� \op o'[.oation and Nature of Proposed Electrical Work: E Le t}'r,c t:, S.tra1 e' W O p4Ne y7pt�e n1.1....^-.1\ U ? Z ,O Completion ofthejollowing table may be waived by the Inspector orFPver. vat I�N of Recessed Luminaires No.of Cell Susp (Paddle)Fans No.of Total Transformers KVA Ct Nu.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming pool Above In- No.of Emergency Lsghuag - emd. grad. 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 Mr Cond. Ton No.of Alerting Devices - No.of Waste Disposers Heat PumpNumber Tons KW No.of Self-Contained - 2 Totals:I I I Detection/Aierting Devices No.of Dishwashers Space/Area HeatingKW' Municipal Local❑Connection ❑ Offer 6 No.of Dryers Heating Appliances KWSecurity Systems:' - No.of Water No.of No. No.of Devices or Equivalent of Heaters KW Signs Ballasts Data No.of ofDevices or Equivalent () No.Hydromassage Bathtubs No.of Motors Total HP telecommunications Wiring; - OTHER: No.of Devices or Equivalent r ..9 Attach additional detail ifdesired or as required by the Inspector of Wires. 17 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. d INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless V 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. c- CHECK ONE: INSURANCE ❑ BOND 0 OTHER 0 (Specify .)3 .) 3 I certify, under the pains and peOnalties ofperjury,that the infant:mien on this application is true and complete, d FIRM NAME\ v : St‘gwn ISie(kr e9 EI-{e}- LIC.NO.: SLicensee: SY\' an " ,e 4r aSignature Si-, L (If applicable,enter"exempt"in the license number line.) el. NO.:Ey y,� Address: oil f r,.,,,ar) pr Ofl•e,.na MO But.Tl.No.: °17yX J •Per M.G.L.c. 147,s.57-61,securityre Alt.Tel.No.: work quires Deparanrnt of Public Safety"S"License: Lic.No. c OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally— i required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent Owner/Agent it Signature Telephone No. I PERMIT FEE: S 5