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Home My WebLink AboutBlde-20-002406 rke Commonwealth of Official Use Only Permit No. BLDE-20-002406 -, -L Massachusetts BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.l/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:10/29/2019 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) 481 BUCK ISLAND RD UNIT 7E Owner or Tenant LUCHT MARGARET R TR Telephone No. Owner's Address M R LUCHT TRUST, 481 BUCK ISLAND RD APT 7E,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 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters New Service 100 Amps Volts Overhead 0 Undgrd 0 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Replace distribution p 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 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 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: Jeffrey T Foss Licensee: Jeffrey T Foss Signature LIC.NO.: 36938 (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: Address:33 SULLIVAN RD,W YARMOUTH MA 026733543 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 a, ill,�'- l.omrnonrutatth of 742 ac fti Official Use Only l ' li= ? ' 2 arimeni [ s Permit No. Q / ,- v 1 k ap o arvcce9 ''' '"`� o t ' Occupancy and Fee Checked ''' �.. �/! OARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 @leave blank) $z _u APPLICATION FOR:PERMIT TO PERFORM ELECTRICALWORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 7 1 v y LEASE PRINT IN INK OR TYPE ALL INFORMATIOII9 Date: /Q City or Town of: Y IOUTH To the Inspec or of Wires: By this application the Emdersigned giv once f his kin,t_e_n2;ierf.71.3„,. ..,wo �ie�cnbed below. 6..) Location(Street&Number) 9 U r /1�IOwner orTenamt � pi/ V��/VVV ��& 1 1"U C Telephone No.p7'YD 2 r5 ��1 q Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service / D Amps /a O/ 2(fbvolts Overhead ❑_ Undgrd,j No.of Meters f New Service Amps / Volts Overhead�ead Undgrd ❑ No.of Meters Number of Feeders and Ampacity t /0 kil t Location and Vature of Proposed Electrical Work / // W l -Ili- matt/ .5Q(i&te A .1I $/fre( .mpletion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cei1.-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 - ;:rnd. ornd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS jNo.of Zones • No.of Switches No.of Gas Burners No.of Detection and Initiative Devices v No.of Ranges No. of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers Heat Pump(Number I Tons I KW �No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loral❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances , Security Systems:* No.of Water , No.of Devices or Equivalent Heaters No.of Dataa Wirr ing Signs Ballasts No.of Devices or Equivalent No.Hydrotnassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: v r Attach additional detail cf desirec4 or as required by the Inspector of Wires. Estimated Value of ec Work [O (When required bymunicipal policy.) Work to Start: � rP P cY) �0 ;� // Inspections to be requested in accordance INSURANCE C VERA :tJE with MEC Rule 10,and upon completion. 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 ermit issuing office. CHECK ONE: WSURANCE $1 BOND ❑ OTHER El (Specify.) GOG %�tak,i/C P�//5Cc t/0 �6 40 I cep', under the pains and p/enalties of perjury,that the information on this application is true and complete. FIRM NAME: _ LIC.NO.: VI Licensee: t eN / Signature n� �� r� 6 r .//�i.��r/,! LIC.NO.: (If applicable. er t' i he!i J Address: if l ' 4 y�i line / 1 n / / Bus.Tel.No.: j `Per M.G.L. c. 147,s.57-61,security work requires 'M i rgt /v/�i Alt.TeL No.: e�6?a!) — OWNER'S INSURANCE WAIVER: I am aware that the Licensee dot of es not have the liabilityc Safety"S"License: Lin.No. ~ / S� insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one)0 owner ❑owner's agent Owner/Agent ' Signature Telephone No. [PERMIT FEE: $