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Home My WebLink AboutBLDE-19-003110 �T Commonwealth of Official Use Only Massachusetts Permit No. BLDE-19-003110 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev.1/07] APPLICATION FOR PERMIT TO PERFORM EL C Pt.i WORK All work to be performed in accordance with the Massachusetts Electrical Code ( ,. C i411 O (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:11/20/2 �/ City or Town of: YARMOUTH To the Inspector of s- o.9..)8 By this application the undersigned gives no ice o is or er men ion o pe e e ca w r escribed below. o Location(Street&Number) 33 CREST CIR r 6 1 I"ryvt _ O Owner or Tena (EST OF) Telephone No. .4..-9,,f) Owner's Address CIO NA MAMBO S A 0240 -5862 Is this permit in conf67iction 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: Wiring for detached building. Completion of the following table may be waived by the Inspector of f 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 Ab 0 In- ElNo.of Emergency Lighting grnove d. 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: 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: $75.00 'L-9 04 a/Zo7 8 . ‘- Cimmonweath.o/2addachetts Official Use Only �l— = apartment o f.dirt Serviced Permit No. ' BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked •�•` [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 INFORPIATI01+0 Date: / ! — / 6 —/ 8 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) 32) C r.e S% Ci I c qt° r/I Owner or Tenant b f 1. PA I pti e r— Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes VNo ❑ (Check Appropriate Box) �v Purpose of Building OUT ` t I--C t 41 Utility Authorization Existing Service )OO Amps ))2V/ ?J(°Volts Overhead D Undgrd 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: IA)I. r-L -0tfitte a-ed- elVi— 80 i C etc, 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 swimmingPool Above:rnd. ❑ stud. 0 Ba In- Nottery.of l Unitsmergency Lighting — 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. Tons No.of Alerting Devices • No.of Waste Disposers Heat Pump I Number I Tons I KW 'No.of Self-Contained y Totals: Detection/Alerting Devices No.of Dishwashers Space/Area HeatingKW' Municipal °�D. Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or Equivalent No.of Heaters KW Data Wiring: 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: 3 C (When required by municipal policy.) Work to Start: t 1-- « _(T Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waiv "by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability i ce including"completed operation"coverage or its substantial equivalent, The undersigned certifies that such cove e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND 0 OTHER ❑ (Specify.) I certzfy, under the pains and penalties of perjury,that the inforrnatio on this application is true and complete. d Q FIRM NAME: I e it SGGLOC fie LIC.NO.: et (3 ! 4 7 Licensee: (I applicable.a Signature LIC.NO.: f Pr +i1 j 1 ' in, �lice---5 m er 1" e) Bus.Tel.No.- F Address: —!"I ( �t l►-e!(� �e�S'1 Gl�I�� Fs J Per M.G.L.c. 147,s.57-61,securitywork requiresAlt.Tel.No.: Department of blic Safety"S"License: Lic.No. — OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage norm required by law. By my signature below,I hereby waive this requirement. I sin the(check one)0 owner ❑owner's agent. Owner/Agent . I Signature Telephone No. ( PERMIT FEE: $