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HomeMy WebLinkAboutBLDE-20-006477 Commonwealth of Official Use Only Permit No. BLDE-20-006477 '0- Massachusetts — 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:6/30/2020 City or Town of: YARMOUTH To the Inspector of Wires: By this application the undersigned gives notice ot his or her intention to ert�lecpae@l described below. Location(Street&Number) 33 CREST CIR r/ Owner or Tenant WALSH MARGARET R(EST OF) Telephone No. Owner's Address CIO NANCY GULLBRANTS,45 CAMBO ST, BROCKTON, MA 02401-5862 Is this permit in conjunction with a building permit? Yes 0 No 0 (Check Ap 1 oilif t Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 0 Undgrd 0 f • O New Service Amps Volts Overhead 0 Undgrd 0 e rlir' Number of Feeders and Ampacity O r'' Location and Nature of Proposed Electrical Work: Permit to close out expired per•. 0 C Completion of the following table may be waived t,L..'+p of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of _ Transformers 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/Alertine 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: 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.t. 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 avic641-Ovnc�2 /z/� Pamir e q. ( 3b8 JUN `,!, 0 Mt; Commonmoa&e///9aaaachu4 a- Official Use Only ,;L s ?- Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS (Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK L. All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 V (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: — 30- 20 Z O City or Town of: YARMOUTH To the Inspector of Wires: ~` By this application the undersigned gives notice of his or her intention to perforin the electrical work described below. Location(Street&Number) -3 3j c reS T C t rJG 141 e3 r Oatilo!'TIt Owner or Tenant D AVL Pa l m melt. Telephone o. a Owner's Address Is this permit in conjunction with a buildin permit? Yes No ❑ (Check Appropriate Box) Purpose of Building SIt1 I A',evalq va0 L Utility Authorization No. �1 Existing Service Amps `J/ Volts Overhead❑ Undgrd❑ No.of Meters 1New Service Amps / Volts Overhead t] Undgrd tiNo.of Meters %Z.11 Number of Feeders and Ampaclty LocationAnd ANature of Proposed Electrical Work: W I r 5 ) i i m iilq p 00 L/ upj et �N a i 4. Co/Ift,/s �J k`' Completion of the following table may be waived by the Inspector of Wires. ''" No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA fr '1 No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimmingpool Above In- No.of Emergency Lighting ' und. ❑ 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 c. Initialing Devices 1 ' No.of Ranges No.of Air Cond. 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 Space/Area Heating KW Local❑ Municipal ❑ er other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of No.of Devices or Equivalent KW 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: /0/ Da ( (When required by municipal policy.) Work to Start: 6-3 0-7,06 Inspectio. • be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless .*ved by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liabili nsurance 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 i% 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: /JQ it .SC#C'&1«' LIC.NO.: /413q�3 < e p Licensee: Signatur LIC.NO.: (If applicable,lit j'exem�t_'i4 e kens nu er ine.) ��Aid.© G us.Tel.No.: Cir 774,g, Address: `(t f- / at /� s� Q Q Z it.TeL No.: ,/Li *Per M.G.L.c. 147,s.57-61,security work requires Departm 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)0 owner 0 owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE:$