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Home My WebLink AboutBLDE-19-1635 Ak0 Official Use Only � � Commonwealth of E Massachusetts Permit No. BLDE-19-001635 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked JRev.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 ININK OR TYPE ALL INFORMATION) Date:9/18/2018 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice Cl his or her intention to pertorm the electrical work described below. Location(Street&Number) 40 CROSBY ST EXT Owner or Tenant GREENE MARJORIE J TR(EST OF) Telephone No. Owner's Address GREENE DRAGON RLN TRUST,40 CROSBY ST EXT,SOUTH YARMOUTH,MA 02664 Is this permit In conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Split NC,hang TV's,&install dimmers. 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 0 In- o No.of Emergency Lighting grnd. grnd. ,Battery Units No.of Receptacle Outlets No.of Oil Burners 'FIRE ALARMS I 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 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,otDevices or Equivalent No.Hydromassage Bathtubs No.of Motors 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 ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: PAUL J VIOLETTE Licensee: Paul J Violette Signature LTC.NO.: 20858 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:18 ANCHOR DR,FORESTDALE MA 026441822 Mt.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) El owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$50.00 era- b 11Ase 1 ammonmeaah yy��/o`tt/aeeetcluesetfe Official Use Only `nr .(JeparLaent oyin J Permit No. srviu! Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev, 1/07] (leave blank) ;� �, �s �� APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code evim, ( � : (ILEASE PRINT ININK ORTYPE ALL INFORMATION) Date: 9 sz-cnntlzoo w a .- o City or Town of: YARMOUTH To the Inspector of Wires: U pvj.o this application the undersigned gives notice of his orIher intention to perform the electrical work described below. -B a I1 tion (Street&Number) q C ray b, re .J 5 d ner'or Tenant a,5 1-,-,Ke Telephone No. m - Oyvner's Address Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 0 Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead 0 Undgrd 0 -= No.of Meters Number of Feeders and Ampacity • Location and Nature of Proposed Electrical Work: in Io As+ Ai. sets,"+ , ( —� srn.sctt; t�u„3 'T-0 Completion of thefollowiny table InT.,be waived by the Inspector of Wires. No.of Recessed Luminaires Na,of Cell.-Snsp.(Paddle)Fans No.of Total Transformers KVA _ No.of Luminaire Outlets No.of Hot Tubs Generators KVA • No.of Luminaires Swimming Pool Above 0 In- No.of mergenty Lightingerred. grnd. 0 Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS (No.of Zones C" No.of Switches No.of Gas Burners No.of Detection and Initiating Devices VNo.of Ranges No.of Air Cond. Total No.of Alerting Devices No.of Waste Disposers Heat Pump I Number'Tons I KW No. of Self-Contained t Totals; Detection/Alerting Devices ,4•4 No.of Dishwashers Space/Area Heating KW Local Municipal Connection 0 �? 4 No.of Dryers Heating Appliances KW Security Systems:* No.of Water No,of No.of Devices or Equivalent "7-- Heaters No.of Data Wiring: - Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No of Devices or Equivalent OTHER: Attach additfonal detail ff desired or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start 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 cove is in force,and has exhibited proof of same to the permit issuing office. ) CHECK ONE: INSURANCEzw. BOND 0 OTHER 0 (Specify:) e I cer8fy, under the pains and penalties of perjury,that the information on this application is true and complete. , FIRM NAME: v' ;o 1.e.+ k Floc- LL C. � /� LIC.NO.:_c A a Licensee: PetK( v:n 1 l Signature (�w"•�/,j,%Q.. -51-- LIC.NO.: (Ifapplicable.enter"exempt"in the license number e.) - Address: 1$ 4,,,, 6� Drtt,-r- rores4th, 4 rev► oae y y Bus.Tel.No.: tss-Cr ne- J `Per M.G.L.c. 147,s.57-61,securitywork requiresLicense: AIG Tel.No. $Og- Zoy_ r�ja- c.No. — OWNER'S INSURANCE WAIVER: I am aware that theaDepartment doestnot have the liability insurance coverage normally *cc required q� by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner 0 owner's agent tOwner/Agent Signature Telephone No. 1 PERMIT FEE: $