HomeMy WebLinkAboutE-18-685 S'Igiel Commonwealth of OffcialUseOnly •Massachusetts Permit No. BLDE-18-000685
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
fRev.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:8/3/2017
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 described below.
Location(Street&Number) 9 EIDER ST
Owner or Tenant COVELL RICHARD B Telephone No.
Owner's Address 9 EIDER ST,YARMOUTH PORT, MA 02675
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check opriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead 0 Undgrd ❑ !_ No
New Service Amps Volts Overhead 0 Undgrd 0/ �y f
Number of Feeders and Ampacity (� iJ1Vl%
Location and Nature of Proposed Electrical Work: Remodel kitchen Pub ffjlive
Completion of the following table may be wa ].;.;Z of Wires.
No.of Recessed Luminaires 7 No.of Ceil:Susp.(Paddle)Fans No.of . .
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 8 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 1 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Tool No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: I Detection/Alerting Devices
No.of Dishwashers 1 Space/Area heating KW Local 0 Municipal 0 Other:
•Connection
No.of Dryers Heating Appliances KW Security Systems:"
No,of Devices or Enuivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Enuivalent
No.Hydromassage Bathtubs No.of Motors. Total HP Telecommunications Wiring:
No.of Devices or Enuivalent
•
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: James A Richardson
Licensee: James A Richardson Signature LIC.NO.: 31497
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address:250 VFW DR,APT 10,ROCKLAND MA 023701163 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:$7100
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N -a1 11 rsf r•,rnt o -Piro Jervicet Permit No.
\\\ ( Occupancy and Fee Checked
J BOARD OF FIRE PREVENTION REGULATIONS 1/07) • (have blame)
APPLICATION FORIPERMET TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusera Electrical Code(MEC),527 CMR 1200
(PLEASE PRINT IN INK OR TYPE ALL INFORhh4T70I9 Date: T-3- /7
L^ City or Town of: YA_RMO VTH To the InspeUor of FVires:
o ThyrA. By this application the pndersiped notice fhis rn her intention to perform the electrical work described below.
•
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Location(Street'&Number) �! �' ( l/�_ �-(� --- �������hr
rev i •
Owner.orTenant 131�}G{/'-Co.a. ��� (90 GHQ V ��/ rL[d
11J o Owner's Address Ei�zr g R( ` Telephone No.
V cn 4p, Is this permit in conjunction with_la building permit? Yes
Purpose of Bffidiag /2e....5� .` E"---- No ❑ (Check Appropriate Bor)
w Q !IV
Utility Authorization Na._—____________
a
E�sting Service /0[J Amps /aj /Zt(OVottr Overhead ❑IIndgrd No,of Meters
L.,.„ m
New Service Amps / Volts Overhead❑ Undgrd ❑ Nd,of Meters
Nnmber of Feeders end 43:opacity
Location and Nature of Proposed Electrical Work.
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. - •-_ _ _ - Completion of the follrrwin_e table mry be waived by the Inmeetor of Wn-et
• No.of Recessed Lomhaairn 7 INo_of Cell.-Stip.(Paddle)Fans IN'o•of Total
LTraasformers KVA
No. of Ltuninaire Oatletr INo.ofEfotTubs Generators • KVA •
• No. of Luminaires I Pool Above In- No.or r,me-g-enry Lagnunq -
Swiminblg And. =rad. Q IEattorvIInits •
No.of Receptacle Oa-Se's 5> No.of OE Barriers HIE ALARMS IN*.of Zones -
No.of Switches / No.of Gas Burners No.of Detection and
• Laifiatffiz Devices
No.of Ranges Ha of.Air Cond. Tons 14o.of Alm-tint Devices
• No.of Waste Disposers IHeatDampINumber ITons IKW ITto.ofSelf-Contatnrd -
Totals: Detecfion/AIerttna Devices
No. of Dishwashers / . ISpaee/Area Heating KW Local Q MwaSdpat -
Coanettion 0 other
No.of Dryers Heating Appliances KW Security Systems:*
No.of Water No.of Devices or EQtuvalent
Heaters KW No. of No. of Data Wiring:
Signs Ballasts Na of Devices or Equivalent
No,Hydromassage Bathtubs No.of Motors Total Hp 'Telecommunications Wiring
Na of Devices or Equivalent
OTHER
— Attach additional detail''desired or as required by the Inspector of Wires.
Estimated Value of Electrical W ori 407 gam' (When required by municipal policy.)
Work to Start g-3-/7 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 covers a is in force,and has exhibited proof of same to the permit issuing office.ONE: NSURANCE (' BOND 0 OTHER 0 (Specify)
I certify,under the pains and penalties of perjury,that the information on to
FIRM NAME: application is true and compfde
SftT �5 r LIC.NO,:
Licensee
G Yee irr Signat¢ LIC N0:£ j 1X47
Address:appldress le,enter "cceanet"in a license mzmber line) Bas.Tel.No:
Address • (/F,y� , f-. a .�lx�f i. illi - --nyI
J `Per M.G.L.a. 147,s.57-61,securitywork requiresAlt.Tel No. 7 )i
Department of Public Safety"S"License: L c.No.
e-t OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance coverage nly
required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner 0 owner's a t
S Owner/Agent
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Signature Telephone No. I PERMIT'FEE:S.
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