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Home My WebLink AboutBLDE-18-002670 (31 Oak Avenue) Commonwealth of Official Use On& Massachusetts Permit No. BLDE-18002670 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev.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:11/3/2017 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_ Odes�ibe,�U d below.I Location(Street&Number) WILLOW ST ' Ak µ"V Owner or Tenant YARM CAMP GROUND ASSOC INC Telephone No. Owner's Address C/O LEE W ERICKSON,455 QUINAPDXET ST,JEFFERSON, MA 01522-1461 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 0 Undgrd 0 No.of Meters Jctw Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace service&add basement lights&smoke detectors. (31 OAK AVENUE) 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 O KVA No.of Luminaires Swimming Pool grnd.Above ❑ In- ❑ No.of Emerge�4 ing grnd. Battery lions No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS .. . a.e O No.of Switches No.of Gas Burners No.of Detection and Initiating Devices /WA, A <9� No.of Ranges No.of Air Cond. Total No.of Alerting Devices O Tons No.of Waste Disposers Ileat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW Local 0 Municipal 0 Oth O Connection Systems:*S Y / No.of Dryers Heating Appliances KW Security No.of Devices or F,aui valent l 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 IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail tf 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:) 1 certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Paul J Petersen -. Licensee: Paul J Petersen Signature LIC.NO.: 14110 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:155 QUAKER MEETINGHSE RD, EAST SANDWICH MA 025371311 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 ,�. _ lammoruoeal7h of rr/addac and Of cciiall U]se On / __. cx7 c7 Permit No. £ 1 d7 . 7(Q ,.! =few `2eparlmant pi vire Serviced Occupancy and Fee Checked • L= BOARD OF FRE PREVENTION REGULATIONS eve 1/07] (Icave blank) .... .,i, APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 sik (PLEASE PRINT IN INK OR TYPE ALL INFORM/17101V Date: 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) 31 Oct - Aut CYC Gal) Owner'orTenant Lee E,rcctA.SO,\ Telephone No. Owner's Address 455 &,,,'ria pcxe't 3t Je Pic r5sn M .4 n_15.2.2- Is (cyZ2- Is this permit in conjunction with a//building permit? Yes ✓ No ❑ (Check Appropriate Box) ' Purpose of Building (h5 lul( T90 ndu.C:On Utility Authorization No. 8I Existing Service 3 0 Amps tete/ u°/ Volts Overhead y Undgrd❑ No.of Meters I New Service WO_ Amps 12O / 2q0Volts Overhead Er Undgrd ❑ No.of Meters I 1 _ Number of Feeders and.kmpacity 3 w;r- too j Location and Nature of Proposed Electrical Work: 2e.p l&c Z s0`u;Ce , a,ab 6G5ent pmt+ , I.yIAFs , svvkol.tl. del-ec(or5 _ r--.1.\--15:, Completion of the fallowing:table may bewailed by the Inspector of Wirer. CI} ,� a) o.of Recessed Luminaires INo.of Ceti.-Snsp.(Paddle)Fans 11 No.of Total Transformers ICVA i cn Qi No,of Luminaire Outlets INo.of Hot Tubs Generators • INA t, fro.of Luminaires Above In- No.of Ener en Lighting Ll6[ O ,o (Swimming Pool amd. ❑ gid. ❑ Battery Uni s ry o cr?��0,z Tlo,of Receptacle Outlets No.of OH Burners FIRE ALARMS INo.of Zones LU -- E '11`7.0,of Switches No.of Gas Burners No.of Detection and • • • Initiating Devices [ t_ No.of Ranges No.of Air Cond. TonsTons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number (Tons I KW No.of Self-Contained ' Totals: Detection/Alerting Devices No.of Dishwashers • Space/Area Heating KW LocalMunicipal ❑Connection ❑ oth?r No.of Dryers Heating Appliances KW Security Systems;` No.of Water I o . of No.of Data W Devices or Equivalent Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail ifdesired or as required by the Inspector of Wires. Estimated Value of Electrical Work: It Sod•on. (When required by municipal policy.) Work to Start I\ 4 4 ( ( 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 cove5ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER 0 (Specify.) I certify, under the ins and genetics'ofperjury,that the information on this j application is bite and complete. FIRM NAME: a,.) \ kiextpsgr (r:ce S.th Elk;e i e4 r, LIC.NO.: ( lam{ 1O Q Licensee: 4G.,., 1 QeAeJc- r Signature ) LIC.NO.: (If applicable,enter"exempt"i the license man her line) Address: 24 MI/I 6• so.vduit�fii MA 0253 Bus.Tel.No.:?a t{p7 J `Per M.G.L.c. 147,s.57-61,securitywork requiresAlt.Tel.No.: Department of Public Safety"S"License: Lic.No. �— - OWNERby'S INSURANCE WAIVER: I am aware that the Licensee doer not have the liability insurance coverage normally Owgiired/Ag law. By my signature below,I hereby waive this requirement I am the(cheek one)0 owner 0 owner's agent. j Signature Telephone No. I PERMIT FEE: $