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HomeMy WebLinkAboutBLDE-22-003140 Commonwealth of Official Use Only , Massachusetts Permit No. BLDE-22-003140 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:12/2/2021 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) 184 SOUTH SEA AVE UNIT 8 Owner or Tenant MAZIARSKI MILLICENT Telephone No. Owner's Address 19 ROBERT CIR, NO GRAFTON, MA 01536 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 A ❑ No.of Meters Number of Feeders and Ampacity k)I (i 7-PT, Location and Nature of Proposed Electrical Work: Exterior service repairs. 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 Initiatine Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Ti 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 ❑ Municipal ❑ Other: Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Ballasts Data Wiring: Heaters Siens No.of Devices or Eauivalent 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 my 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 c tL � � j C�- —�y �0beL I t - 2021u C/� aa'' y�j� ommonwsa[th o`///aseac�u�st>`a Official Use Only iY I � - :''�'>fi,� , � Permit No. �22 `3 ( 4 sparfmsnl o/giro Serviced i';' BOARD OF FIRE PREVENTION REGULATIONS [Rev /c 107)y and Fee Checked (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I... 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: / 2 — / — 2-0 Z/ 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. C.) Location(Street&Number) j g Sd vTN SQ_ lGr/e CO ,_Q Owner or Tenant m i I I%L kg 9 Z i a r S1li Lt c/. it IV'S7 Telephone No.'' �t Owner's Address J S I Is this permit in conjunction with a buildingrmit? Yes Pe ❑ No (Check Appropriate Box) ! Purpose of Building (i 1 C Servtc. . / G/Rr T Utility uthorization No. ! ExistingService / �) I �0 Amps `h7/ 2'{Q Volts Overhead Undgrd❑ No.of Meters 7, New Service Amps / Volts Overhead❑ Undgrd 0 No.of Meters 4 Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: f'1V S Seta. -e..ci C JVL,T re- C/t,P Card-..r l L 1 ,t-- . i Completion of the followinktable mg be waived by the Inspector of Wires. ii.: No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total . Transformers KVA '::.t No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires SwimmingAbove In- No.of Emergency Lighting Pool grind. ❑ and. ❑ 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. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local 0 Municipal Connection ❑ Other No.of Dryers Heating Appliances Kam, Security gistems:4 No.of Water No.of Devices or Equivalent Heaters KW No.of No.of 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: ('© (When required by municipal policy.) Work to Start: /13D 20 l Inspections to .. requested in accordance with MEC Rule 10,and upon completion.1 INSURANCE C VE GE: Unless waiv.. .y the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability i•. ranee including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coy ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE LSI BOND 0 OTHER 0 (Specify:) I certify,under the pain and penalties of perjury,that the information on this application is true and complete. �� FIRM NAME: pi{t S'cifd.en e-r' LIC.NO.: (3 9 Licensee: SignatureT1c) t„,4,4LIC.NO.: (if applicable./e�e "exem t"in he license,num�er lure.) Address: vl r�( (c`J l� i-e-e. iQs e U�, Bus.Tel.No.: < r)F 7.74 ,2 7 Tel.No.: •Per M.G.L.c. 147,s.57-61,security work requires Departmof Public Safety"S"License: Alt Lie.No. (f 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 agent. Owner/Agent Signature Telephone No. ` PERMIT FEE:$ c j U I