Loading...
HomeMy WebLinkAboutBlde20-001210 Commonwealth of Official Use Only 0Massachusetts Permit No. BLDE-20-001210 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•9/4/2019 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) 28 MEADOWBROOK RD Owner or Tenant CAMPBELL WILLIAM Telephone No. Owner's Address CAMPBELL GAIL A, 28 MEADOWBROOK ROAD,WEST YARMOUTH, MA 02673 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: Install generator(11 Kw w/16 circuit switch) 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 1 KVA 11 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 1 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.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: EUGENE J EMERSON Licensee: Eugene J Emerson Signature LIC.NO.: 20136 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: PO BOX 1122, ORLEANS MA 026531122 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: $50.00 Cr st l'07 ll' ? ' ii Official Use Only • i hi 2adamoi o/glre SOWCOI Puit No. 0 BOARD OF FIRE PREVENTION REGULATIONS Fee Checked Occupancy sod Lj _ [ �] (brve want) • APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK -0' All wort to be performed is ace idsooa will'the Meesecheeetts Electrical Coda%SC).527 CM 12.00 i (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9/4/2019 ACity or Town of: Yarmouth To the Inspector of Wires: -.'S Location this application the undersigned gives notice of his arbor intention t o perfoen the electrical work described below. [.cation(Street d Number) 28 Meadowbrook Rd ei Owner or Tenant William Campbell Sr Tei.phew No. 2 Owner's Address 9R Maarinw,aline olL Pa O 1 Is this permit is anjNnetlus with a indiig pew? Yes 0 No ® (Cheek Appropriate Box) ce Purpose of Beildl■g Home Utility Autlnrisatlu,No. V Uglily Service 100 Amps 120 1240 Volt (widow® Underd❑ No.of Messrs 1 0Now, mps A / Volts Overhead 0 Undgrd ElNo.of Meters Number of Fellers and Ampa-Yy Cr) Loomis.and Nature e[PnpandMIN all Wet Install 11 KW Generac generator with 16 circuit ., automatic transfer switch Comfit**ease fslb+%Lebk a�he walked by d ie la�dbr Winner. otal W No.of Recessed Lmahnirs. Nee of CeirSeup.(Pads)Fans �Neo..oy Transformers '(KYA C No.of L-Nsiab Odd* Ns.of Het Tubs Generators KVA -t- No.of Laud-.us swimming Peel ❑ III- ❑ re*or aruarpeaey wauat fs ad. mud. i[fettle►Units No.of Ram[tads Outlets No.of OR Barnes FIRE ALARMS Na of Reuss No.of BwMehss No.of Gas Berms 'Re.of IWsdlu and lnWsdes>Dookes t,_, No.e(Reaps No.of Air Cud. Total No.of Almtlsg Devices N..of Worsts DYposw� gestNe■1!I NNuuber Tens KW of SeliFCo�M Tstalss t 4 No.of Dldrwaia"s Spam/Ana Heaths KW Led❑ ❑ Mir No.of Doyen Heaths;Appliames KW • Pin of 1 or EmdvYut No.of Water Kvt+ No.of NO.of Data WMeg: HeHeatersSlane Mesh: Ns.Hydroaesse a Bathtubs No.of Melon Total HP T Nor.of Oarless er OTHER: Attach mid:bad detail!tasked ores required by the Jerpecsor of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Skirt: 9/4/2019 Inspections to be requested in accordance with MEC Ride 10,am upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the pertbemence of electrical weak may isms melees the licensee provides proof of liability insurance including"completed operation“coverage or its dal equivalent. The undersigned certifies d ist such coverage is in force,aid has exhibited proof of same to the permit Mining office. CHECK ONE: INSURANCE © BOND 0 OTHER 0 NNW) I cafe wisp rkopans and/+ all+ tken albs iSbrmadrn ow ems tpp&asel w A awe and.Nadu[& FIRM NAME: Emerson Electrical Construction In LIC.NO.: A20136 i lane: Eugene Emerson signature -"LC.NO.:E38135 qq Addr PO o applicable,ester x 1122 the MA.02653 Ault.Tell.r o;;5�b8 �6�� 133 *Per M.G.L.c. 147,s.S7-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I on aware that the Licensee doer not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. 1 am the(check one)0 owner ❑owner's agent. Owner/Agent Signature Telephone N.. I PERMIT FEE:S 50.00