The URL can be used to link to this page

Home My WebLink AboutBlde-20-000322 Commonwealth of Official Use Only Lint* Massachusetts Permit No. BLDE-20-000322 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:7/19/2019 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) 15 ROBERTA DR Owner or Tenant LUKES KONSTANTINA B TR Telephone No. Owner's Address THE EIGHT THIRTY ONE RLTY TRUST,24 HADWEN RD,WORCESTER, MA 01602 Is this permit in conjunction with a building permit? Yes 0 No ❑ (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: Check house to restore power. 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 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/Alertine Devices No.of Dishwashers Space/Area Heating KW Local 0 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 Siens 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: WILLIAM W GREER Licensee: William W Greer Signature LIC.NO.: 19867 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:275 OCEAN ST, HYANNIS MA 026014740 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 lit CsTtt�. t' I -M. Commonmsa of///as.6ac�resalfs • Official Use Onbz- /—,' c7 n.firs Serviced Permit No. ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy.and Fee Checked ritzy. l/07]7] (leave blank) 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 INFORMATIOI9 Date: 7 (1 ( 9 City or Town of: YARMOUTH To the Inspector of Tres_ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) t 5— R p. taN 0. (3r:, V k Owner.or Tenant 1<e h Sfo►h f-.., g , L u(`es •cr.+g-3.-ed? Telephone No. Owner's Address a 1( f•(a.olt- c.0 e tet 0.. o ac.t t.o 0 v-C.,a ir @r M A O l Cp 0 2 Is this permit in conjunction with a building permit? Yes ❑ No $ (Check Appropriate Box) Purpose of Building 15 CZ ,j, I 1 ', -i el Utility Authorization No. Existing Service e o Amps (Zo / ,2 ttoVotts Overhead Set Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd t;r ❑ No.of Meters Number of Feeders and Ampacity I„,a ee•.1,.1 e 4:6l..a.f4 pW34- resao�JkS Grooti4 eqiS4:•-1S.2ooAw,f, Location and Nature of Proposed Electrical Work: S t r.J% c.4 -l-o b r �� f �►S alt �OKe3 For of e., J p c.. i vl at.,-1:1,/ roo wl 0 c....-.a. OO4rA0o.- to a 4sk.- Wt4 $ems CO Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cet1-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swinimin Pool Above In- No.of Emergency Lighting g arnd. _rad. Battery Units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS [No.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I ting Number I Tons f I KW No.of Self-Contained Totals: Detection/Aler Devices No.of Dishwashers Space/Area HeatingMunicipal KW Local❑Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent Heaters ' 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 additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electitcal Work (When required by municipal policy.) Work to Start 7(1 (91(9 Inspections to be requested in accordance with!AEC Rule 10,and upon completion. p p on. 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 ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: r l k • Gt,t44, 67. r e e J- r (tc,1i,r c.t.k-,. LIC.NO.: l Licensee: Co IR -' t-r.ttv- Signature Co (If applicable, t`�9:� �el/u-� LIC.NO.: ltcable,enter"exempt"in the license timbber line.) Address: J Q C et. $ T., -� Bus.Tel.No.:5 03?�St ® t; y-2 ey�t't1K' t LS G.OL Alt.Tel.No.: ,J 'Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally 5 required by law. By my signature below,I hereby waive this requirement. I am the(check one)0 owner ❑owner's agent. Owner/Agent I Signature Telephone No. {PERMIT FEE: $