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Home My WebLink AboutBlde-20-001704 Commonwealth of Official Use Only 4; Permit No. BLDE-20-001704 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:9/30/2019 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) 16 APRIL WAY Owner or Tenant FRITSCH LYNDA A Telephone No. Owner's Address 10 MEDWAY RD, CHESTNUT RIDGE, NY 10977-7010 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 ❑ Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replacement boiler. 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- ❑ 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 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 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: $50.00 01,(Sc IdV ? - ki C.ommoraoaaith of i i c ac �3 Official Use Only __ +_: cc'�� nn • _�1- = .ccam`�, arfmant ol5tre Jary ces : Permit No. �C J �' ={='• Occupancy and Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS rRev. 1/07j r • (leave blank) APPLICATION FOR:PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with'the Massachusetts Electrical Code (NLEC1,427 CMRg I2.D0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI019 Date: ( ' Z ( l City or Town of: YARNIOUTH To the Inspector of Wires: By this application the pride fined vA o Y)o{his s• er intention to perform the electrical work described below. __.__,.__._.....,. _Location(Street&Number) ! I • ,..7, �Owner or Tenant r A �,,y(� � Telephone No.$? —367 279 7 •.:,; ' lk-. Owner's Address li Is this permit in conj ction with a buii ' g permit? Yes W �n ❑ No (Check Appropriate Box) Purpose of Building '� , z • („ rst g S r^ UtilityAuthorization No. } lxistiag Service Amps F / Volts Overhead ❑ Undgrd❑ No.of Meters ? l _�1 New Service 4Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity -_,._.. ----..-- ..Location and Nature of Proposed Electrical Work: ` ��i!fir ,--,►f/d�zir+ Completion of the follc win&table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell-Sup.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingPool Above In- No,of Ir mergeacy LIghtm srnd arnd. Battery IInits g No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS 'No.of Zones No.of Switches No.of Gas Burners No.of Detection and J Initiating Devices No.of Ranges Tons No.of Alerting Devices No. of Air Cond. No.of Waste Disposers Heat Primp Number Tons No.of Self-Contained Totals:I { IKW Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal connection o Other No.of Dryers Heatia A g ppliant es , 'Security Systems; 4 No.of Water No.of No.of Devices or Equivalent vNo.of Heaters lCWSighs Ballasts Data Wiring: 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 Valu of Electrical Work: (When required by municipal policy.) ci Work to Start: '7 - Z‘--( Inspections to be requested in accordance with MEC Rule 10,and upon completion. , �u INSURANCE COVERAGZ.: Unless waived by the owner,nopermit for the performancepss 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 p` BOND ❑ OTHER ❑ (Specify:) I certzfy, under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Licensee: LIC.NO.: Si slur —�--- (Ifapplicab "in th Ii ....- LIC.NO.:��. Address: tuber line Bus.TeL No.: O Q 41-6 a C1L G ,J Per M.G.L. c. 147,s.57-61,security work requires Depent of Public SafetyAft.TeL No.: — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liabilityLin.No. 5 Q insurance coverage norm required by law. By my signature below,I hereby waive this requirement I am the(check one 0 owner Owner/Agent0 owner's a ent Telephone No. PERMIT FEE: .S' ill Signature