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Home My WebLink AboutBLDE-19-005993 Commonwealth of Official Use Only IL. , Permit No. BLDE-19-005993 Massachusetts • BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] 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 IN INK OR TYPE ALL INFORMATION) Date:4/23/2019 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) 216 SOUTH ST Owner or Tenant LERZ ALFRED A TRS Telephone No. Owner's Address LERZ DIANE B TRS, 35 APPLEWOOD DR, SOMERS, CT 06071 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: Replacement furnace. 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 ❑ In- ❑ No.of Emergency Lighting grnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners 1 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 ❑ Municipal ❑ 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 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 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: KUNG-PO TANG Licensee: Kung-Po Tang Signature LIC.NO.: 52286 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:518 COTUIT RD, MASHPEE MA 026492351 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 7 ( l - tg &&:. c $[ ,Vigo f�. __�� //1ac�cusaEfs Official Use Only _'��— ry� c-7� :1-47*- t�=_ _ 1JaParfinarrf f..J ra Permit No. �l Q –� lg 3 ° arvices t`r r--�' i, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked �� w 'ev. 1107) eave blank APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL 1 " All work to be performed in accordance with the Massachusetts Electrical Code WORK � ,� '' (MEC),527 CMR 12.00 w, _-= ,F ; (PLEASE PRINT IN INK OR TYPE ALL INFORMA770N) Date: — Z >i t City or Town on YARMOUTH —/ `� `" ` To the Inspector of Wires: By this application the pndersi ed. ves trce his . h. intention to perform the electrical work described below. " ' O �' Location(Street&Number) l�I o t 0 ' ICOwner or Tenant (,Lr ? 1 Owner's Address Telephone No.I-b-7 (3_ 63`> "Is this permit in conju tion�'jt�h a bu ding ermit? Yes Purpose of Building f25 1 d(�'7 f No (Check Appropriate Boz) Utility Authorization No. Existing Service Amps / Volts Overhead 0. Undgrd Ej No.of Meters New Service Amps / Volts Overhead Ei Number of Feeders and Ampacity Undgrd No.of Meters Location and Nature of Proposed Electrical Work: /1 thGe re i Q' rig=L P 6`a-u) s, e.ceJ 1 Thnotheolliblembew . dhZns,ector o Wires. No.of Recessed Luminaires No.of CeiL-S (Paddle)Fans o.of Total Transformers No. of Luminaire Outlets No.of Hot Tubs KV Generators KVA No.of Luminaires Swim v Above In- •o.o mergency Rn b Pool i_j �d g No.of Receptacle Outlets I gid � Batte • Units No.of Oil Burners FIRE ALARMS No.of Zones \./ No.of Switches No.of Gas Burners o.of Detection and No.of Ranges Initiating Devices ti No. of Air Cond. No.of Alerting Devices No.of Waste Disposersp umber Heat Pam Tons Totals . Tons_ o.of elf-Contain• No.of Dishwashers DetectioNAlertin_ Devices Space,Area Heating KW Local 1-1 Q Municipal No.of Dryers Connection Other Heating Appliances KW Security Systems:* No.of ater No.o No.of Devices or E.uivalent Heaters Kms' o.of Data Wirin Si s Ballasts No.of Deices or E.uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E.uivalent Estimated Valuep Electrical Work Attach additional detail if desired or as required the Inspector _ (When required by municipal policy.) of Wires. -------- Work to Start: / ons to be requested in ,'v INSURANCE COVERAGE: nle�way d by the owner, permitdfor the e rth MEC Rule performance of 10, and upon completion. the licensee provides proof of liability insurance includingp electrical work may issue unless undersigned certifies that such coverage is in force,and has'exhibit d proofrof same to the pon"coverage oermit r its substantial issuing equivalent. The C) CHECK ONE: INSURANCE 44,. BOND 0 OTHER I certify, under the pains and penalties o � (Specify:) Q) FIRM NAME: fPerluD',that the information on this application is true and complete Licensee: FD LIC.NO.: (If applicable enter Signator LIC.I / a Address: Pt 'n the ice ber 1'n ) a'(If o i / ` ANA �e GLIA`d z Bus.Tel No.: i Sz�cS Alt.Tel.No. J Per M.G.L. c. 147,s.57-61,security work requires Dep. cot of Public Safe : e.No. „t OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurLance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one 0 owner Owner/Agent Y Signature El owner's a_ent Telephone No. PERMIT FEE: $ S p /