Loading...
HomeMy WebLinkAboutBLDE-17-004535 J °.. Commonwealth of otreialUseOnly 'E' ` Massachusetts Permit No. BLDE-17-004535 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.I/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 ININK OR TYPE ALL INFORMATION) Date:3/8/2017 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to pertorm the electrical-work described below. Location(Street&Number) 7 YACHT AVE Owner or Tenant HERMAN CHRISTOPHER A TRS Telephone No. Owner's Address HERMAN SUSAN C TRS,61 HOYLE ST, NORWOOD, MA 02062 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. 2205044 Existing Service 100 Amps Volts Overhead 0 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 and wire addition • Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.ofTotal Transformer is KVA No.of Luminaire Outlets No.of Hot Tubs Cenerato KVA No.of Luminaires Swimming Pool Above 0 In- ❑ No.of y L'� p\ gird. gird. Batte Isis `r.'/ No.of Receptacle Outlets No.of Oil Burners FIRE ALA . f�a,0 No.of Switches No.of Gas Burners No.of Detection a P Initiating Devices t'X71 No.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposer heat Pump Number Tons KW No.of Self-Contained 0 Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal 0 Othee� Connection No.of Dryers heating Appliances KW Security Systems:* / �Q No.of Devices or Eauivalent / No.of Water KW No.of No.of Data Wiring: Heater Signs Ballasts No.of Devices or Eauivalent No.Hydromassage Bathtubs No.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: (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 ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Edward M Lynch Licensee: Edward M Lynch Signature LIC.NO.: 35609 (If applicable,enter"exempt"in the license number line) Bus.Tel.No.: Address:25 WIDGEON LN,WEST YARMOUTH MA 026733818 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) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$75.00 EcU 3/401(7J_ 4F'L etNI*-tz StAd 7 1.17 i atfg-v cots evu oa J �`1� \� l.Co. . n. crith oil/M-44.,chu�sc� Oficial Use 1Onrly^3 " ^\1 `\� T,_ arcrLnent c{._Yiw.�crvisd .Pert>rit No. 6I �4 _ G �V 3 BOARD OF FIRE PREVENTION REGULATIONS 0c �ryand Fee Checked - rRev. 1/07] fezve bleak) APPLICATION• FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code A C), .-7 CMR 1200 (PLEASE PRINT DJINKOR TYPE ALL ITT'ORhf4770N) Date: • • ® City or Town of: YARMOUTH To thel sect. of"fires: LU .y this application the pndersigned rues n•tice o hi• orb. intention to perform the electrical work described below. o ;'- .cation (Street&Number) etc 1 _pi ,• . eV a /ownerortenazt L yr ' l D� lW ' c I Telephone No. owner's Address �q/z-e• �� o •¢ this permit in conjure on with a balding permit? Yes No t / 49 ❑ (Check Ap,eropr a B0) _ I urposeofEtul' o 'dif n ��� ,; ,� ( � Utility Authorization Nn. 9y/ `a c listing Service foo Amps (//2 /2 tOVolts Overhead *. Undgrd❑ No.of Meters New Service Sea_ amps /1'Q /9%10 Volts Overhead[lig IIndgrd❑ No. of Meters Number of Feeders and Ampadty t-- Location and Nath _of Proposed e 'cel Work. • Ii/ i 0 f4 01i 04�d ©, ii ; u,; , p • — � - �..- 1. ec"'� �� r •J. ---- --.. . . . _. . Complexion of the followint table may be waived by the lrspectar of}Tv-er• No.of Recessed LuminairesINo of Cerl�tssp.(Paddle)Fags • INo'of Total Transformers KVA Na. of Luminaire Optic, INo.of Hoe Tubs [Generators • KVA ' - • No. of Luminaires ISwirnm7"g Pool Above ❑ Is- iNo.of ane-Henry Ltginag orad. arnti Battery merg . Na. of Receptacle Ott e±s . No.of Ott Bt:ners `ETRE ALARMS INo.of Zones No.of Switches No,of Gas Bm-aers Na_of Detecnon and Isfti !Devices No.of Ranges Na.ITonns of Air Cond. ToHo,of Atxt@g Devices • s No.of Waste Disposers IHeatTotals: DePump I Number Tons KW Na.lof Self-Contained t-ction/Alerdac Devices Na. of Dishwashers 'Spam/Area Heating KW' Local❑Muzicip Connectional 0 Othn- No, of Dryers hintingAppliancesSecurity Systems;° No. of Water No.of Devices or Equivalent Heaters KW No. of No. of Data Wiring: Signs Ballasts No.of Devices or Equivalent No,Hydromassage Bathtubs No, of Motors Total HP ITelecommnaicatioas Wiring Na of Devices or Equivalent OTHER _ • Attach additional detail pr desired oras required by the Inspector of Fires. Estimated Value o Ele trial Work (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE r 0 r • ' E: 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'S BOND 0 OTHER 0 (Specify.) I certify, ander the paints and penalties of perjury,that the information on on this appEcation is true and complete FIRM NAME: LIC NO.: Licensee ip I </ signature 'rJl///ir������ / �_ i LIC NO.:� (Jf applicably) r"in the e mumbler f �n �L7 Address: !- � / n ,/�q / Bus.Tek No: / �(04 a re /,J//f1/�� �/ Alt.Tel No. '0 J `Per M.G.L.a. 147, sJ57-61,security work regnires fir., AA, �Staf License: Lic.No. — OWNER'S INSURR SCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage n omally S required y at By signature below,I hereby waive this requirement. I am the(cheek one)0 owner 0 owner's agent I Signature Telephone No. I PERMITTEE: S