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HomeMy WebLinkAboutBlde-19-002712 0aCommonwealth of Official Use Only Massachusetts Permit No. BLDE-19-002712 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•11/5/2018 City or Town of: YARMOUTH To the Inspector of Wires: p By this application the undersigned gives notice of his or her intention to perform the electncal work described below. , Location(Street&Number) 12 WOODBINE AVE Owner or Tenant GRAY CAROL Telepho' oi,. ',d, / A Owner's Address 12 WOODBINE AVE,WEST YARMOUTH, MA 02673 ' 'r Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap 1F, : i ,' Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Aill IDI New Service Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Repairs to service. 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/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ 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: Scott M Laperriere Licensee: Scott M Laperriere Signature LIC.NO.: 32399 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address: 17 ROBINWOOD RD, BUZZARDS BAY MA 025325124 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 EL- ----610/t-i Ao uvr patIvr ma i klcv'/ e r5> t t I co(e 22 3 c, cc) zll- 630)(> x i Commonwealth of///assachussffs Official Use Only -_ S-2 ( Z cc�� c��7 n Permit No. )eparfinenit oi,�irs Services f 1 ' Occupancy and Fee Checked �6< 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 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: ///j 1 g City or Town of: YAR1VIOUTH To the Inspector of Wires: By this application the undersigned gives notice of his or hat intention to perform the electrical work described below. Location (Street&Number) /2 0 d elf e N e Owner or Tenant C//149 L 6 1-0}-v Telephone No. Owner's Address Sit 1 s this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) --8i w urpose of Building --c/ , t Ili :A,•4,01./- Utility Authorization No. ® xisting Service Qt Amps Zp/ . tVolts Overhead ©�Undgrd❑ No.of Meters j s; 11 ew Service Amps / Volts Overhead❑ Und grd ❑ No,of Meters 4` umber of Feeders and Ampacity tion and Nature of Proposed Electrical Work: } Completion of the following table may be waived by the Inspector of Wires. "" "�� No.of Recessed Luminaires No.of No.of Cei1.-Susp.(Paddle)Fans Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA Cl - No.of Luminaires Swimming Pool Above ❑ a 'No.of Units Lighting erred. crud. ❑ 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. Toial Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number I Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑Connectio Connection ❑ Other No.of Dryers Heating Appliances Kam, Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters ' Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: - ti OTHER: No.of Devices or Equivalent Q.) Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of Electrical Work Work to Start: � (When required by municipal policy.) CO, c9-j Inspections to be requested in accordance with MEC Rule I0,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 cove is in force,and has exhibited proof of same to the permit issuing office. t... CHECK ONE: INSURANCE BOND ❑ OTHER 0 (Specify:) I certify, under the pains and penalties o perjury,r}5 that the informatia n this a plic is true and contplet FIRM NAME: S (^ ) *t. f,t ' ^ Licensee:_—V.. Signature LIC.NO.: 5 V , (If applicabl ,enter er t in the license number lin g ��// . Address: /y Bus.Tel.NoO.• � j .Per M.G.L. c. 147,s.57-61,security work requires Dep ent of Public Safety"S"License: Alt.Tel. cl�No.�• — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally— S required by law. By my signature owner below,I hereby waive this requirement. I am the(check one 0 % Owner/Agent ❑owner's a eat Signature. Telephone No. PERMIT FEE: $ o Y9R TOWN OF YARMOUTH • - o BUILDING DEPARTMENT p -y 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1263 Fax 508-398-0836 K. Elliott, Inspector of Wires kelliott(a�yarmouth.ma.us November 6, 2018 Scott Laperriere 17 Robinwood Road Buzzards Bay, MA 02532-5124 Location: C. Gray, 12 Woodbine Avenue,West Yarmouth. Permit Number: BLDE-19-002712 Dear Scott; The above noted location inspection failed to pass for the reason(s) listed. Article 230-54(C) Service head location. Article 250-53(A)(2) Supplemental electrode required. Please forward the required re-inspection fee of eighty dollars ($80.00) to this office and advise when the corrections have been made and when access may be gained,to the property, for the re-inspection. If you have any questions please do not hesitate to contact me. Sincerely, Town of Yarmouth, Building Department K. Elliott, Inspector of Wires