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HomeMy WebLinkAboutE-19-3319 � • Commonwealth of Official Use Only V L' Massachusetts Permit No. BLDE-19-003319 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked tRev.l/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 MINK OR TYPE ALL INFORMATION) Date:11/30/2018 City or Town of: YARMOUTH - To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertonn the electrical work described below. Location(Street&Number) 3 CAPE ISLE DR Owner or Tenant HEITER GEORGE L TRS Telephone No. Owner's Address HEITER FRIEDERIKE,24 STONE RIDGE RD,WESTFORD,MA 01886 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 ❑ No.of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Septic pump&alarm 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- ❑ 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 1 Totals: Detection/Alerting 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 1 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 ❑ BOND 0 OTHER 0 (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: THOMAS S KIMBALL Licensee: Thomas S Kimball Signature LIC.NO.: 31130 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:224 DEXTER LN, ROCHESTER MA 027704119 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:$50.00 &� 0°1 e 4 _ ammomoa t&o f///asaac ifs Official Use Only rt a Merriman! Th �s 7 �i� Merriman!of Thre J Permit No. , ” I `_ISI Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. Iro73 (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK I • All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.110 sO (PLEASE PRINT EV INK OR TYPE ALL INFORMATIOA9 Date: (\I)t 01 act F 1`7 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. 17 11.4 don(Street&Number) B Cf$pc, z13IC1 Qa-i w donerbrTenant Gepp p tit-Z.9 ` ' ` Telephone No. � , ; 6 er's Address 'S A - -_ T 1Is tris permit in conjunction with a buildingpermit? d 0 (Check Appropriate Box) Yes Noppro riau U ' � Ito tOf Badding Utility Authorization No. ILIo i g Service 100 Amps %IO ;gip Volts Overhead Undgrd❑ No.of Meters I ew service Amps / Volts Overhead ix m n ❑ Undgrd ❑ No.of Meters Nu . . of Feeders and Ampacity Location and NtitareofProposed Electrical Work: U',IL;Mc inq C0. Q`1pot �y t'? ,1, nIAAn Completion of thefollowingtable may be waived, by the Inspector of-Wires. No.of Recessed Luminaires No.of Cal.-Susp.(Paddle)Fans • „o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming pool Above 0 In- No.of Lmergency Lighting grad. arnd. Battery Units 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 Air Cond. Ton No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number ITons I KW No.of Self-Contained - Totals; Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ocher No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of Devices or Equivalent Heaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent 4 No.Hydromassage Bathtubs No.of Motors Total HP 'Telecommunications Wiring: OTHER No.of Devices or Equivalent -Attach additional derail ifderired or as required by the Inspector of Wires. © • g Estimated Value o Electrical Work (When required by municipal policy.) Work to Start: (10-9 Inspections to be requested in accordance with MEC Rule 10,and upon completion. aINSURANCE 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 C undersigned certifies that such cov ge is in force,and has exhibited proof of same to the permit issuing o ce. ,]G CHECK ONE: INSURANCE [BOND 0 OTHER 0 (Specify:) Cormurx• ) 877.4119 NI I certify, under the pains and penalties of perjury,that the informatio this application • true and complete. FIRM NAME: S LIC.NO.: Licensee: 0 vis V)yi ,Alt Signature (Ijapp[icable, t �--' LIC.NO.: . . b 1— 2 re igemain he lice a number(jtpe.) v i Bus.Tel.No: Address. l/L.7 p t�tyyQ I(U h W'P �tL�Q j `Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety Alt.TeL No.: ��. • L OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.insurance o. � required bylaw. Bymysignature coverage nrmally q� below,I hereby waive this requirement. Nun the(check one)0 owner 0 owner's agent t Owner/Agent Signature Telephone No. I PERMIT FEE: $ 50'-