The URL can be used to link to this page

Home My WebLink AboutBlde-19-006452 Commonwealth of Officia452l Use Only Massachusetts Permit No. BLDE-19-006 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:5/15/2019 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) 166 SILVER LEAF LN Owner or Tenant ROCCO MICHAEL B Telephone No. Owner's Address ROCCO ANN E,2787 SCARBOROUGH RD, CLEVELAND HEIGHTS, OH 44118 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 ❑ 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: Upgrade service,wire master bedroom, laundry,dining room, &porch addition. 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 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 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: Neil Schoener Licensee: Neil Schoener Signature LIC.NO.: 13949 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:44 TRADERS LN,W YARMOUTH MA 026733333 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:$150.00 i— 1- .C(1761 fe Ff 5( it-di 2t at4tt kg- "P1' ic# 1 \_�YF Commonwealth of Ma..4sacha4eft Official Use Only - - 4t .1J T Permit No. epartrranf o crvicc.! y -,ram, ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS {Rev. 1/07] (leave blank) - (� ' APPLICATION FOR=PERMIT TO PERFORM ELECTRICAL WORK �' All work to be performed in accordance with the Massachusetts Electrical Code (MEC),527 12.D0 ,., (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / 41 `9 City or Town of: YARMOUTH To the Inspecto of Wi es: By this application the undersigned glues otie of his or her intention to perform the electrical work described below. • _,. Location (Street&Number) L cS j/ V tQ !-C4'� �< \l Owner'or Tenant/Mt/ f' 0 G C O Telephone No. �J Owner's Address Is this permit in conjunction with a bu" ipermit? ding . Yes _ No ❑ (Check Appropriate Box) Purpose of Building 4Z)lIT)0!1 �04 V 6-SCrvltic Utili uthorization N P0\911 Existing Service J5 e Amps AO Volts Overhead Undgrd 1719 ,of Meters New Service �j� l37 Number !r0 Amps /X/I O Volts Overhead❑ Undgrd No.of Meters /pOG N mber of Feeders and Ampacity t Location and Nature of Proposed Electrical Work: 3 , �� 4 D` .. ' • Per f91)D01u/l O / 'A " C, I , . IJG- - rtca-e Completion of the followinz 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 =rad. arnd 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 Total - No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers• Heat Pump Number Tons KW o,of Self-Contained - Totals: I __I No Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal - Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No. of No.of Devices or Equivalent Heaters KW No. of Data Wiring: Siffrts 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 lec .cal Work �S Qa v (When required by municipal policy.) Work to Start: / j Inspecti ns td o be requested in accordance with MEC Rule 10,and upon completion. v INSURANCE VE GE: Unless waive, .y the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability inl,. ce including"completed operation"coverage or its substantial equivalent, The undersigned certifies that such cover.: is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE P. BOND 0 OTHER ❑ (Specify:) ,___ I certify, under the pains a penalties of perpiqs, tat the information on this application is true and completes��> f L! v FIRM NAME: •Q ( v N-C� c� �} Licensee: G Signature !�'�X�/' _� LIC.NO.: / (Ifapplicable. enter "exempt"in the license number line.) g '• LIC.NO.: PP Address Bus.TeL No.: J Per M.G.L. c. 147, s. 57-6 I,security work requires DePSafety artment of Public "S"License: Lic.Alt.Tel No.: No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the(check one) ❑owner ❑owner's agett, Owner/Agent al Signature Telephone No. I PERMIT FEE: $ I CD