HomeMy WebLinkAboutBLDE-21-0067258 1.Ai\ Commonwealth of Official Use Only
0Massachusetts Permit No. BLDE-21-006725
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.I/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:5/20/2021
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 b to
Location(Street&Number) 200 SOUTH SEA AVE t 324 I
Owner or Tenant REISMAN PAUL P elephone No.
Owner's Address REISMAN MARIA,75 JOHNSON RD, SCARSDALE, NY 10583
Is this permit in conjunction with a building permit? Yes 0 No 0 (Check ropriate Box)
Purpose of Building Utility Authorization N..
Existing Service Amps Volts Overhead ❑ Undgrd * ,. 4;1% . ,rse//
New Service Amps Volts Overhead ❑ Undgrd r. l
Number of Feeders and Ampacity O
Location and Nature of Proposed Electrical Work: Rewire kitchen&add 4 recessed lights.
•
Completion of the following table may 4 Spector of Wires.
No.of Recessed Luminaires 4 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 8 No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches 10 No.of Gas Burners No.of Detection and
Initiating Devices
No.of Ranges 1 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 1 Space/Area Heating KW Local 0 Municipal 0 Other:
Connection
No.of Dryers Heating Appliances 1 KW 2.5 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: Richard A Haarman
Licensee: Richard A Haarman Signature LIC.NO.: 33511
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No.:
Address: 18 Holmes Rd, Harwich MA 026452219 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
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>�I g 21.partsnent o`�rre Jervics6 Permit No. /
1 BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1 07cy and Fee Checked
�,1' (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: 5/14/2021
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)200 South Sea Ave
Owner or Tenant Reisman Telephone No.
_Owner's Address
Is this permit in conjunction with a building permit? Yes ❑■ No ❑ (Check Appropriate Box)
I a° Purpose of Building Dwelling Utility Authorization No.
Exist in Service 200 Amps 120 /240 Volts Overhead 0 Undgrd 1-1 Undgrd of Meters 1
New;Sevice Amps / Volts Overhead 111
Undgrd ID No.
of Meters
i
INumbek of Feeders and Ampacity
i Locatkin and Nature of Proposed Electrical Work: Rewire Kitchen,Add 4 recessed lights to Ceiling.
1 Completion of the following table may be waived by the Inspector of Wires.
Total
No.of Recessed Luminaires 4 No.of Ceil:Susp.(Paddle)Fans Tf
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Aboven In- nNo.of Emergency Lighting
grnd. I I grnd. i I Battery Units
No.of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones
oNo.of Switches 10 No.of Gas Burners No. Initiating
and
on Devices
No.of Ranges 1 No.of Air Cond. Tons Tons No.of Alerting
Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: Detection/Alerting Devices
No.of Dishwashers 1 Space/Area Heating KW Local Municipal ❑ Other
Connection
No.of Dryers Heating Appliances 1 KW2.5 Security Systems:*
No.of Devices or Equivalent
No.of Water Kam, 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: 5/13/2021 Inspections 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 ❑ OTHER 0 (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: Snows Fuel, LLC Asa
'///�� LIC.NO.•2946A1
Licensee: Richard A Haarman Signature 4��1 LIC.NO.:33511 E
(If applicable,enter "exempt"in the license number line.) Bus.Tel.No.•508-789-5410
Address: 18 Holmes Rd Orleans,MA 02653 Rick@snowsfuel.com Alt.Tel.No.:508-255-1103
*Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.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 agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.