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Home My WebLink AboutE-18-2993 • Commonwealth of offieialuseOnly I .w'�, . �E !►i Massachusetts Permit No. BLDE-18-002993 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:11/20/2017 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 wor,k.,descri below. C461-P--0 Location(Street&Number) 39 CROSBY ST EXT 61-�I—�-+ L' L_, Owner or Tenant SMITH HARVEY B JR Telephone No. Owner's Address SMITH LINDA A,9389 SANTA MARGARITA RD,VENTURA,CA 93004 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check A u Bol Purpose of Building Utility Authorization No. ` O Existing Service Amps Volts Overhead 0 Undgrd 0 No.o e O �////�/ New Service Amps Volts Overhead ❑ Undgrd 0 No.of Me O C�� Numberof dNatuFeedersend ofAmpoed ty I��47 /\ //� Location and Nature of Proposed Electrical Work: Remodel kitchen&den. /�,/VOt-`'/)/JA�,v Completion of the following table maybe waived by thej"s'8'r o Wires. No.of Recessed Luminaires 10 No.of Ceil:Susp.(Paddle)Fans No.of Transformers K No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ElNo.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 8 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges 1 ' No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers - Heat Pump Number Tons 1 KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers 1 Space/Area Heating KW Local ❑ 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 Total IIP Telecommunications Wiring: No.of Devices or Equivalent OTIIER: 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: Peter T Schock Licensee: Peter T Schock Signature LIC.NO.: 12888 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:1144 WASHINGTON ST, NORWOOD MA 020624330 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $75.00 r I 7a ' Commor.wealg of//laddacl.•.dolle eviDfneial Use t_ apartment c-� n('� •PermitNoG1 „/' JJcpartment of.Piro&Mad .• Occupancy and Fee Checked �� BOARD OF ARE PREVENTION REGULATIONS ;Rev. 1/073 • cleave blank) �— APPLICATION FOR.PERMIT TO PERFORM ELECTRICAL WORK AU work to be performed in accordance with the Massachusetts Electrical Cod: C),527 CMR 12.00 (PLEASE PRINT INLYKORTYPE ALL INFORM/1TI079Date: � I al5 ' ti 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 electical work described below. Location(Street&Number) 3q c.r ossY Si &I1 Owner•orTenant CA1'0I o 0(3 `' Telephone No. Owner's Address S A M e � —� Is this permit in conjunction with a building permit? Yes ✓ No ❑ (Check Appropriate Box) (� ' Purpose of Building S(N 3I.Q 1u4&I I v l ' Qes Utility Authorization No. Existing Service 100 Amps j 2 2LIDVolts Overhead ❑✓ Undgrd Fl New Sece ❑ NoofMeters _� .Amps / Volts Overhead❑ Undgrd ❑ Nd.of MetersNumber of Feeders and Ampacity LoonandNreofposedlWk: WInINCS FDYL KtkhQ �VDJULA 4 Completion ofthe folowinz table may be waived by the Inspector of FPQrI No.of Recessed Luminaires I p No.of Cerl-Susp.(Paddle)Fans • (Transformers Total. KVA W 5 ,. No. of Luminaire Outlet !No.of Hot Tubs (Generators • KVA • C4 mm . No. of Luminaires (Swimming Pool d.Above 0 In- ❑ INo.or emergency Lighting - . Q C7 arnErnd. Battery Unit No. of Receptacle Outlet No.of Ott Burners 'FIRE ALARMS INo.of Zones Na. of Switches �No.of Gas BnrnersINC.of Detection and - V Initiating Devices No. of Ranges ITotal - No.of Air Cond. Tons INC.of Alerting Devices • Heat Pump Number Tons KW (No.of Self-Contained Totals: [Detection/Alertin?Devi No.of Waste Disposers ces No. of Dishwashers ` Space/Area Heating KW LoralMuaitapal ❑Connection 0 Other No. of Dryers Heating Appliances KW Security Systems:° No.of W titer No.of Devices or Equivalent 4. Heaters KW No. of No.of Data Wiring: Sins Ballast No.of Devices or Equivalent 3' No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: '-i OTHER: Na of Devices or Equivalent •n • OU Attach additional detail if delved or as required by the Inspector of Fives. Estimated Value of Electrical Wort aro (When required by municipal policy.) J Work to Start: 1 (-1$-1 '7 lotions to be requested in accordance with MEC Rule 10,and upon completion, J- INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue t nless vthe licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent The undersigned certifies that such c,o_s,,�a is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE LY BOND 0 OTHER 0 (Specify:) I certify, under the pains and penalties of perjury,that the infortnation oonthis appiication is true and coznpieta , e p p FIRM NAME: Pe kel S cHocK F,1QCTn�IG 75,4c_ LIC.NO.:M (C-8 D 8 Licensee: pt)-f), - ' SL}4oe Signature C) u (Ifapplicable, enter'¢empt"inthelicense 7~ �u Lit. (/t Ger line) ` ' Bus.TeL No.: ' -7 '-'d'3& Address, 1144 Ie)4s f(pgc ,� NOkJ J 'Per M.G.L.c. 147,s.57-61,securityrk requires� �c Ni 502afety"S" ense:n Alt Tet No.: . _cefr OWNER'S INSURANCE WAIVER I am aware that theDepartmenticensee does nor have the liabilityLin.insurance coverage �( � required by law. By my signature below,I herebywaive this requirement. eowner normally ay 5 Owner/Agent I am the(check one) ❑owners agent. Signature Telephone No. I PERMIT FEE:S